Provider Demographics
NPI:1578188819
Name:AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES - SC LLC
Entity Type:Organization
Organization Name:AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES - SC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:M
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-349-8388
Mailing Address - Street 1:2255 GLADES RD STE 228W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7391
Mailing Address - Country:US
Mailing Address - Phone:561-349-8388
Mailing Address - Fax:561-658-6142
Practice Address - Street 1:2104A WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5941
Practice Address - Country:US
Practice Address - Phone:864-336-2323
Practice Address - Fax:864-336-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty