Provider Demographics
NPI:1770187817
Name:PACE SET MEDICS LLC
Entity Type:Organization
Organization Name:PACE SET MEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-PARAMEDIC
Authorized Official - Phone:347-886-5828
Mailing Address - Street 1:223 PELTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1537
Mailing Address - Country:US
Mailing Address - Phone:347-886-5828
Mailing Address - Fax:
Practice Address - Street 1:223 PELTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1537
Practice Address - Country:US
Practice Address - Phone:347-886-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory