Provider Demographics
NPI:1265686158
Name:ALLEGIANCE OCCUPATIONAL HEALTH
Entity Type:Organization
Organization Name:ALLEGIANCE OCCUPATIONAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-768-7766
Mailing Address - Street 1:1 S JACKSON SQ
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1457
Mailing Address - Country:US
Mailing Address - Phone:517-768-7766
Mailing Address - Fax:517-768-7767
Practice Address - Street 1:1 S JACKSON SQ
Practice Address - Street 2:SUITE 101
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1457
Practice Address - Country:US
Practice Address - Phone:517-768-7766
Practice Address - Fax:517-768-7767
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGIANCE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital