Basic Information
| Provider Information | |||||||||
| NPI: | 1144495243 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OCCUPATIONAL HEALTH CENTERS OF OHIO, PA, CO | ||||||||
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| OtherOrganizationName: | CONCENTRA MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5080 SPECTRUM DR STE 1200W | ||||||||
| Address2: | |||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750014624 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2884 E KEMPER RD | ||||||||
| Address2: | |||||||||
| City: | SHARONVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452411820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137712233 | ||||||||
| FaxNumber: | 5136123572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2008 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| AuthorizedOfficialLastName: | ANDERSON | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9723648000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0100X | PT-08544 | OH | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No ID Information.