Provider Demographics
NPI:1215364633
Name:AMERICA CARES TRUST, INC
Entity Type:Organization
Organization Name:AMERICA CARES TRUST, INC
Other - Org Name:AMERICA CARES TRUST
Other - Org Type:Other Name
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-739-3371
Mailing Address - Street 1:5247 HARDING PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2901
Mailing Address - Country:US
Mailing Address - Phone:615-739-3371
Mailing Address - Fax:615-486-4103
Practice Address - Street 1:5247 HARDING PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2901
Practice Address - Country:US
Practice Address - Phone:615-739-3371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
TN48969208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1532934Medicaid