Provider Demographics
NPI:1891965687
Name:INDUSTRIAL HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:INDUSTRIAL HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:STROUD
Authorized Official - Last Name:HITCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-354-8056
Mailing Address - Street 1:7001 HODGSON MEMORIAL DR
Mailing Address - Street 2:SUITE #5
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2549
Mailing Address - Country:US
Mailing Address - Phone:912-354-8056
Mailing Address - Fax:912-352-9800
Practice Address - Street 1:7001 HODGSON MEMORIAL DR
Practice Address - Street 2:SUITE #5
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2549
Practice Address - Country:US
Practice Address - Phone:912-354-8056
Practice Address - Fax:912-352-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11372261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD29773Medicare UPIN