1528419744 NPI number — AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES-NC PLLC

Table of content: (NPI 1528419744)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528419744 NPI number — AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES-NC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN ARTHRITIS & RHEUMATOLOGY ASSOCIATES-NC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528419744
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2255 GLADES RD STE 228W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431-7391
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-349-8388
Provider Business Mailing Address Fax Number:
561-658-6142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2125 VALLEYGATE DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304-3753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-336-1600
Provider Business Practice Location Address Fax Number:
561-828-8292
Provider Enumeration Date:
06/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
FOWLER
Authorized Official First Name:
JACK
Authorized Official Middle Name:
RHEUMATOLOGY
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
561-349-8388

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  33712 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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