Basic Information
Provider Information
NPI: 1720499346
EntityType: 2
ReplacementNPI:  
OrganizationName: WORKPLACE HEALTH SERVICES, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: IU HEALTH WORKPLACE SERIVCES
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 950 N MERIDIAN ST
Address2: SUITE 200
City: INDIANAPOLIS
State: IN
PostalCode: 462041077
CountryCode: US
TelephoneNumber: 3179631616
FaxNumber: 3179631621
Practice Location
Address1: 402 W WASHINGTON ST
Address2: ROOM 041
City: INDIANAPOLIS
State: IN
PostalCode: 462042243
CountryCode: US
TelephoneNumber: 3179632035
FaxNumber: 3179631621
Other Information
ProviderEnumerationDate: 05/16/2014
LastUpdateDate: 05/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MCBRIDE
AuthorizedOfficialFirstName: LORI
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 3179631611
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: METHODIST OCCUPATIONAL HEALTH CENTERS
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: RN, COHN-S
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261Q00000X  Y Ambulatory Health Care FacilitiesClinic/Center 

No ID Information.


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