Provider Demographics
NPI:1932774924
Name:FAST DRAW EXPRESS LLC
Entity Type:Organization
Organization Name:FAST DRAW EXPRESS LLC
Other - Org Name:FAST DRAW EXPRESS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHLEBOTOMIST TECHNICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:EXPRESS
Authorized Official - Last Name:ESTERAS
Authorized Official - Suffix:
Authorized Official - Credentials:CCMA
Authorized Official - Phone:135-254-4984
Mailing Address - Street 1:9292 BELVEDERE ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5609
Mailing Address - Country:US
Mailing Address - Phone:352-544-9842
Mailing Address - Fax:
Practice Address - Street 1:12595 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5068
Practice Address - Country:US
Practice Address - Phone:352-544-9842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-23
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory