Provider Demographics
NPI:1841771599
Name:OCCUPATIONAL MEDICINE RESOURCESPC
Entity Type:Organization
Organization Name:OCCUPATIONAL MEDICINE RESOURCESPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/EMPLOYEE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-542-1615
Mailing Address - Street 1:PO BOX 3427
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-0427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1619 N GREENWOOD ST STE 208
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2656
Practice Address - Country:US
Practice Address - Phone:719-542-1615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine