Healthcare Provider Details

I. General information

NPI: 1386833291
Provider Name (Legal Business Name): AMERICAN CURRENT CARE PA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 47TH STREET SUITE 100
BOULDER CO
80301
US

IV. Provider business mailing address

5080 SPECTRUM DRIVE SUITE 1200 WEST
ADDISON TX
75001-4625
US

V. Phone/Fax

Practice location:
  • Phone: 303-541-9090
  • Fax: 303-541-9393
Mailing address:
  • Phone: 800-364-8000
  • Fax: 214-775-4502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. WILLIAM TOM FOGARTY
Title or Position: PRESIDENT
Credential: MD
Phone: 800-364-8000