MEDICARE: AMERICAN CURRENT CARE PA

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	261Q00000X	Clinic/Center
2	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1114116811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN CURRENT CARE PA

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DRIVE
Second Line	:	SUITE 1200 WEST
City	:	ADDISON
State	:	TX
Zip	:	75001-4625
Country	:	US
Telephone Number	:	800-232-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 SPRING PARK ROAD
Second Line	:	SUITE 100
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216
Country	:	US
Telephone Number	:	904-399-5959
Fax Number	:	904-396-5777

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

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	08/02/2010

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Directions to “AMERICAN CURRENT CARE PA ” Practice Location

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