Organization
FASTTRACK IMMEDIATE CARE OF ALBANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARED DERANEY SOLE MEMBER (OWNER)
(888) 728-0882
Entity
Organization
Contact information
Practice address
2822 NOTTINGHAM WAY, ALBANY, GA 31707-7629
(229) 496-1193
Mailing address
PO BOX 4380, ALPHARETTA, GA 30023-4380
(888) 728-0882
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
GA48063
GA
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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