Provider Demographics
NPI:1215623152
Name:PERFORMANCE AUTO
Entity type:Organization
Organization Name:PERFORMANCE AUTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FEASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-751-8000
Mailing Address - Street 1:502 MILLSAP RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-9635
Mailing Address - Country:US
Mailing Address - Phone:704-751-8000
Mailing Address - Fax:
Practice Address - Street 1:825 S POST RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6932
Practice Address - Country:US
Practice Address - Phone:704-781-7502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle