Basic Information
Provider Information
NPI: 1316189145
EntityType: 2
ReplacementNPI:  
OrganizationName: CONCENTRA HEALTH SERVICES, INC.
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Mailing Information
Address1: 5080 SPECTRUM DR
Address2: SUITE 1200 WEST TOWER
City: ADDISON
State: TX
PostalCode: 750014648
CountryCode: US
TelephoneNumber: 8002323550
FaxNumber: 2147754515
Practice Location
Address1: 1 PILLSBURY ST
Address2:  
City: CONCORD
State: NH
PostalCode: 033013556
CountryCode: US
TelephoneNumber: 6032232300
FaxNumber: 6032289730
Other Information
ProviderEnumerationDate: 03/25/2009
LastUpdateDate: 03/25/2009
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: NEWTON
AuthorizedOfficialFirstName: KEITH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT / CEO
AuthorizedOfficialTelephone: 8002323550
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QH0100X NHY Ambulatory Health Care FacilitiesClinic/CenterHealth Service

No ID Information.


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