Organization
FASTVAX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIEVERT LARSSON (CEO)
(215) 996-1400
Entity
Organization
Contact information
Practice address
1500 HORIZON DR, ST 120, CHALFONT, PA 18914-3966
(267) 308-0534
(267) 308-0533
Mailing address
1500 HORIZON DR, SUITE 120, CHALFONT, PA 18914-3966
(215) 996-1400
(267) 308-0533
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD061592L
PA
Other
Enumeration date
07/25/2008
Last updated
01/17/2011
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