Basic Information
| Provider Information | |||||||||
| NPI: | 1376083642 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WORKPLACE HEALTH SERVICES, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | IU HEALTH WORKPLACE SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 950 N MERIDIAN ST | ||||||||
| Address2: | STE 950 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462041077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179631616 | ||||||||
| FaxNumber: | 3179631621 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 N BOEKE RD | ||||||||
| Address2: | DOOR 23 | ||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477115925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8127733043 | ||||||||
| FaxNumber: | 8127733023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2017 | ||||||||
| LastUpdateDate: | 03/14/2017 | ||||||||
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| AuthorizedOfficialLastName: | DARROCA | ||||||||
| AuthorizedOfficialFirstName: | GERALDINE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3179631618 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | METHODIST OCCUPATIONAL HEALTH SERVICES | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.