FAST PACE MISSISSIPPI PLLC NPI 1740947019

NPI Information

NPI: 1740947019
Provider Name: FAST PACE MISSISSIPPI, PLLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 25D2158625

Address:
305 HILL ST
ELLISVILLE, MS
ZIP 39437
Phone: (601) 800-0118
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FAST PACE MISSISSIPPI, PLLC is a rural health clinic center in Ellisville, MS. FAST PACE MISSISSIPPI, PLLC NPI is 1740947019. The provider is registered as an organization entity type.

The provider's business location address is:

305 HILL ST
ELLISVILLE, MS
ZIP 39437-521
Phone: (601) 800-0118

The provider's authorized official is Sydni Clemmons .
The authorized official title is Credentialing Manager and has the following contact phone number (901) 351-1791.

The CLIA number assigned to this NPI record is 25D2158625 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2021 and was last updated on 11/22/2021.

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

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: 4/28/2024

NPI Synchronization or Removal

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