Provider Demographics
NPI:1629209937
Name:OCCUPATIONAL DRUG TESTING LLC
Entity Type:Organization
Organization Name:OCCUPATIONAL DRUG TESTING LLC
Other - Org Name:OCCUPATIONAL WELLNESS SCREENING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-314-1333
Mailing Address - Street 1:340 HARVEY RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3361
Mailing Address - Country:US
Mailing Address - Phone:603-314-1333
Mailing Address - Fax:
Practice Address - Street 1:340 HARVEY RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3361
Practice Address - Country:US
Practice Address - Phone:603-314-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH78132083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty