Basic Information
Provider Information
NPI: 1144716077
EntityType: 2
ReplacementNPI:  
OrganizationName: AMERICAN CURRENT CARE P.A .
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CONCENTRA URGENT CARE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5080 SPECTRUM DR STE 1200W
Address2:  
City: ADDISON
State: TX
PostalCode: 750014624
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 700 E BEARDSLEY AVE STE 100
Address2:  
City: ELKHART
State: IN
PostalCode: 465143365
CountryCode: US
TelephoneNumber: 5742068010
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/03/2018
LastUpdateDate: 04/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HASSETT
AuthorizedOfficialFirstName: ROBERT
AuthorizedOfficialMiddleName: G
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 9723648000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QU0200X  Y Ambulatory Health Care FacilitiesClinic/CenterUrgent Care

No ID Information.


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