Provider Demographics
NPI:1689906091
Name:OCCUPATIONAL HEALTH CENTER CASTLETON
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTER CASTLETON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHNEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-6341
Mailing Address - Street 1:8177 CLEARVISTA PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1662
Mailing Address - Country:US
Mailing Address - Phone:317-621-7808
Mailing Address - Fax:
Practice Address - Street 1:8177 CLEARVISTA PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1662
Practice Address - Country:US
Practice Address - Phone:317-621-7808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN050050681261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine