MEDICARE: AMERICA CAN

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1093124851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICA CAN

Provider Business Mailing Address
First Line	:	325 W 12TH ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-6502
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 W 12TH ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-6502
Country	:	US
Telephone Number	:	214-944-1947
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MARIAN HAMLETT
Credential	:
Telephone Number	:	214-944-1947

Provider Enumeration Date	:	08/06/2014
Last Update Date	:	08/06/2014

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