MEDICARE: FAST TRACK BILLING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1639484025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAST TRACK BILLING INC

Provider Business Mailing Address
First Line	:	50 W BROADWAY
Second Line	:	SUITE 1000
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-2020
Country	:	US
Telephone Number	:	801-883-8315
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 W BROADWAY
Second Line	:	SUITE 1000
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-2020
Country	:	US
Telephone Number	:	801-883-8315
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EKATERINA SERGEEVA
Credential	:
Telephone Number	:	801-883-8315

Provider Enumeration Date	:	08/10/2010
Last Update Date	:	08/10/2010

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