Healthcare Provider Details
I. General information
NPI: 1215113212
Provider Name (Legal Business Name): AMERICAN CURRENT CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/21/2008
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
219 CAPITOL STREET SUITE 2
AUGUSTA ME
04330-6235
US
IV. Provider business mailing address
5080 SPECTRUM DRIVE SUITE 1200 WEST TOWER
ADDISON TX
75001-4648
US
V. Phone/Fax
- Phone: 207-629-5005
- Fax: 207-629-5220
- Phone: 800-232-3550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TOM
FOGARTY
Title or Position: SENIOR VP / CHIEF MEDICAL OFFICER
Credential: M.D.
Phone: 972-364-8103