| Fast Pace Kentucky, Pllc | |
|
919 N Main St Madisonville KY 42431-1261 | |
| (270) 228-0592 | |
| Not Available |
| Full Name | Fast Pace Kentucky, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 919 N Main St, Madisonville, Kentucky |
| Authorized Official Name and Position | Sydni Clemmons (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9013511791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fast Pace Kentucky, Pllc Po Box 306414 Nashville TN 37230-6414 Ph: () - | Fast Pace Kentucky, Pllc 919 N Main St Madisonville KY 42431-1261 Ph: (270) 228-0592 |
| NPI Number | 1588321822 |
|---|---|
| Provider Enumeration Date | 11/22/2021 |
| Last Update Date | 11/22/2021 |
| Medicare PECOS PAC ID | 0143525998 |
|---|---|
| Medicare Enrollment ID | O20220108000180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588321822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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