Healthcare Provider Details
I. General information
NPI: 1275571606
Provider Name (Legal Business Name): PACE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2006
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2515 LIFESTYLE WAY STE 101
CHATTANOOGA TN
37421-1985
US
IV. Provider business mailing address
820 FESSLERS PKWY STE 315
NASHVILLE TN
37210-2938
US
V. Phone/Fax
- Phone: 423-698-8971
- Fax: 423-624-5160
- Phone: 615-214-3777
- Fax: 423-624-5160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224P00000X |
| Taxonomy | Prosthetist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THEODORE
MACDONALD
Title or Position: OFFICER
Credential:
Phone: 615-214-3777