| Fast Pace Mississippi, Pllc | |
|
50 Veterans Memorial Dr Kosciusko MS 39090-3424 | |
| (931) 253-1101 | |
| (931) 722-9919 |
| Full Name | Fast Pace Mississippi, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 50 Veterans Memorial Dr, Kosciusko, Mississippi |
| 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 Mississippi, Pllc Po Box 306415 Nashville TN 37230-6415 Ph: (931) 253-1110 | Fast Pace Mississippi, Pllc 50 Veterans Memorial Dr Kosciusko MS 39090-3424 Ph: (931) 253-1101 |
| NPI Number | 1851050579 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 12/09/2021 |
| Medicare PECOS PAC ID | 3678832029 |
|---|---|
| Medicare Enrollment ID | O20211207001587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851050579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Bmc Attala Kosciusko Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 220 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-4311 Fax: 662-290-3255 | |
Trace Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 530 Veterans Memorial Dr, Kosciusko, MS 39090 Phone: 662-289-9155 Fax: 662-289-7752 | |
Trace Medical Clinic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 530 Veterans Memorial Dr, Kosciusko, MS 39090 Phone: 662-289-9155 Fax: 662-289-7752 | |
Kosciusko Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 332 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-1800 |