Provider Demographics
NPI:1881766202
Name:CONCENTRA MEDICAL CENTER - AMS
Entity type:Organization
Organization Name:CONCENTRA MEDICAL CENTER - AMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR 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:972-364-8103
Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-778-4066
Mailing Address - Fax:615-778-9114
Practice Address - Street 1:2410 FRANKLIN PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2227
Practice Address - Country:US
Practice Address - Phone:615-297-1902
Practice Address - Fax:615-297-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Not Answered261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine