Provider Demographics
NPI:1144403346
Name:AMERICAN CURRENT CARE PA
Entity Type:Organization
Organization Name:AMERICAN CURRENT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP / CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-364-8107
Mailing Address - Street 1:5080 SPECTRUM DRIVE
Mailing Address - Street 2:SUITE 1200 WEST TOWER
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:800-232-3550
Mailing Address - Fax:
Practice Address - Street 1:100 SOUTH CHARLES STREET
Practice Address - Street 2:SUITE 150
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2725
Practice Address - Country:US
Practice Address - Phone:410-752-3010
Practice Address - Fax:410-539-7023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD168267Medicare PIN