Provider Demographics
NPI:1689792335
Name:CSC HANFORD OCCUPATIONAL HEALTH SERVICES
Entity Type:Organization
Organization Name:CSC HANFORD OCCUPATIONAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-376-4716
Mailing Address - Street 1:1979 SNYDER ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-5319
Mailing Address - Country:US
Mailing Address - Phone:509-376-4716
Mailing Address - Fax:509-376-1606
Practice Address - Street 1:1979 SNYDER ST
Practice Address - Street 2:SUITE 150
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-5319
Practice Address - Country:US
Practice Address - Phone:509-376-4716
Practice Address - Fax:509-376-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601934315261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine