| Fast Pace Kentucky, PLLC | |
|
757 W Main St Lebanon KY 40033-1838 | |
| (270) 972-4186 | |
| Not Available |
| Full Name | Fast Pace Kentucky, PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 757 W Main St, Lebanon, Kentucky |
| Authorized Official Name and Position | Robert Benson (COO) |
| Authorized Official Contact | 9312531110 |
| 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 | Fast Pace Kentucky, PLLC 757 W Main St Lebanon KY 40033-1838 Ph: (270) 972-4186 |
| NPI Number | 1396402640 |
|---|---|
| Provider Enumeration Date | 11/22/2021 |
| Last Update Date | 11/22/2021 |
| Certification Date | 11/22/2021 |
| Medicare PECOS PAC ID | 0143525998 |
|---|---|
| Medicare Enrollment ID | O20220115000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396402640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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