Fast Pace Mississippi, Pllc

LBN: Fast Pace Mississippi, Pllc
Fast Pace Mississippi, Pllc is an health care organization with primary practice located at 1709 W Quitman St , Iuka MS 38852-7365. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Fast Pace Mississippi, Pllc can be contacted via phone (901) 351-1791, or through Clemmons, Sydni via phone (901) 351-1791.

Contact Information

Primary practice address
1709 W Quitman St Iuka MS 38852-7365
Phone: (901) 351-1791
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clemmons, Sydni
Phone: (901) 351-1791

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1023688918
LBN Legal business name Fast Pace Mississippi, Pllc
DBA Doing business as
Authorized official Clemmons, Sydni
Entity Organization
Organization subpart 1 No
Enumeration date Jul 1st, 2021
Last updated Jul 1st, 2021 - about 5 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 1023688918 NPPES
Mississippi Other 0000 MEDICAID PENDING

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