Provider Demographics
NPI:1437377637
Name:MEDWORK LLC
Entity Type:Organization
Organization Name:MEDWORK LLC
Other - Org Name:MEDWORK OCCUPATIONAL HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:IMBROGNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-449-0800
Mailing Address - Street 1:1435 CINCINNATI ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-4614
Mailing Address - Country:US
Mailing Address - Phone:937-449-0800
Mailing Address - Fax:937-449-0881
Practice Address - Street 1:1435 CINCINNATI ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-4614
Practice Address - Country:US
Practice Address - Phone:937-449-0800
Practice Address - Fax:937-449-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1613078261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========-00OtherBWC GROUP PROVIDER NUMBER