Provider Demographics
NPI:1417262296
Name:OCCUPATIONAL HEALTH CENTERS OF OHIO PA, CO
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTERS OF OHIO PA, CO
Other - Org Name:CONCENTRA MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:ESHELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-232-3550
Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:SUITE 1200W
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:942 CHERRY ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45107-7883
Practice Address - Country:US
Practice Address - Phone:937-783-9355
Practice Address - Fax:937-783-2527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center