Provider Demographics
NPI:1255603684
Name:FAST CARE CLINIC CORPORATION
Entity type:Organization
Organization Name:FAST CARE CLINIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:NARIANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-374-1789
Mailing Address - Street 1:PO BOX 1179
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3795 BUFORD DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4906
Practice Address - Country:US
Practice Address - Phone:866-935-6066
Practice Address - Fax:866-935-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty