MEDICARE: OCCUPATIONAL HEALTH CENTERS OF NORTH CAROLINA, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QH0100X	Health Service Clinic/Center
2	261QP2000X	Physical Therapy Clinic/Center
3	261QX0100X	Occupational Medicine Clinic/Center

General Provider Information

NPI Number	:	1043342751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL HEALTH CENTERS OF NORTH CAROLINA, P.C.

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DR
Second Line	:	SUITE 1200 WEST TOWER
City	:	ADDISON
State	:	TX
Zip	:	75001-4648
Country	:	US
Telephone Number	:	800-232-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	2835 JEFF ADAMS DR
Second Line	:	#A
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1061
Country	:	US
Telephone Number	:	704-342-9011
Fax Number	:	704-342-3812

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

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	01/05/2009

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