NPIMap

Organization Active NPI

Fastvax LLC

  • Clinic/Center
  • Chalfont, PA
National Provider Identifier
1508021858
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD061592L Issued in PA
Legal business name
FASTVAX LLC
Practice address
1500 Horizon Dr
St 120
Chalfont, PA 18914-3966
Phone
(267) 308-0534
Fax
(267) 308-0533
NPI assigned
Jul 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Sievert Larsson
Title
Ceo
Phone
(215) 996-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD061592L PA Primary

Addresses

Primary practice location

1500 Horizon Dr
St 120
Chalfont, PA 18914-3966

Mailing address

1500 Horizon Dr
Suite 120
Chalfont, PA 18914-3966
Phone (215) 996-1400

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295222400000",
    "number": "1508021858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 HORIZON DR",
            "address_2": "SUITE 120",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143966",
            "telephone_number": "215-996-1400",
            "fax_number": "267-308-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HORIZON DR",
            "address_2": "ST 120",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143966",
            "telephone_number": "267-308-0534",
            "fax_number": "267-308-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASTVAX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-25",
        "last_updated": "2011-01-17",
        "status": "A",
        "authorized_official_last_name": "LARSSON",
        "authorized_official_first_name": "SIEVERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-996-1400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "MD061592L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chalfont, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.