Fast Pace Medical Clinic Pllc

LBN: Fast Pace Medical Clinic Pllc
Fast Pace Medical Clinic Pllc is an health care organization with primary practice located at 1359 W Market St , Bolivar TN 38008-1702. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Fast Pace Medical Clinic Pllc can be contacted via phone (731) 361-1003, or through Benson, Robert via phone (931) 253-1110.

Contact Information

Primary practice address
1359 W Market St Bolivar TN 38008-1702
Phone: (731) 361-1003
Fax: (731) 361-1004
Website:
Map and Directions
Authorized official contact:
Name: Benson, Robert
Phone: (931) 253-1110

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1598420929
LBN Legal business name Fast Pace Medical Clinic Pllc
DBA Doing business as
Authorized official Benson, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Nov 1st, 2021
Last updated Nov 1st, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598420929 NPPES
Tennessee MEDICAID 1515574

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