Healthcare Provider Details

I. General information

NPI: 1700056959
Provider Name (Legal Business Name): AMERICAN CURRENT CARE OF NORTH CAROLINA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4917 SOUTH BLVD
CHARLOTTE NC
28217
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 704-395-0064
  • Fax: 704-527-2329
Mailing address:
  • Phone: 800-232-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TOM FOGARTY
Title or Position: SENIOR VP/ CHIEF MEDICAL OFFICER
Credential: MD
Phone: 972-364-8103