Provider Demographics
NPI:1487029906
Name:WELLSPAN OCCUPATIONAL HEALTH
Entity Type:Organization
Organization Name:WELLSPAN OCCUPATIONAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-851-1666
Mailing Address - Street 1:2250 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2857
Mailing Address - Country:US
Mailing Address - Phone:717-851-1600
Mailing Address - Fax:717-851-1610
Practice Address - Street 1:2250 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2857
Practice Address - Country:US
Practice Address - Phone:717-851-1600
Practice Address - Fax:717-851-1610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine