FAST PACE MEDICAL CLINIC PLLC NPI 1407511876

NPI Information

NPI: 1407511876
Provider Name: FAST PACE MEDICAL CLINIC PLLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 44D2145043

Address:
502 ELLINGTON DR
LAFAYETTE, TN
ZIP 37083
Phone: (615) 561-1042
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FAST PACE MEDICAL CLINIC PLLC is a rural health clinic center in Lafayette, TN. FAST PACE MEDICAL CLINIC PLLC NPI is 1407511876. The provider is registered as an organization entity type.

The provider's business location address is:

502 ELLINGTON DR
LAFAYETTE, TN
ZIP 37083-697
Phone: (615) 561-1042
Fax: (615) 561-1043

The provider's authorized official is Robert Benson .
The authorized official title is Coo and has the following contact phone number (931) 253-1110.

The CLIA number assigned to this NPI record is 44D2145043 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2021 and was last updated on 11/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1515574	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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