Provider Demographics
NPI:1063663425
Name:GREENBELT OCCUPATIONAL MEDICAL SERVICES
Entity Type:Organization
Organization Name:GREENBELT OCCUPATIONAL MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:443-524-2737
Mailing Address - Street 1:7933 BELLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3329
Mailing Address - Country:US
Mailing Address - Phone:301-220-1191
Mailing Address - Fax:301-220-2291
Practice Address - Street 1:7933 BELLE POINT DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3329
Practice Address - Country:US
Practice Address - Phone:301-220-1191
Practice Address - Fax:301-220-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty