Provider Demographics
NPI:1992864664
Name:INDUSTRIAL HEALTH SERVICES
Entity Type:Organization
Organization Name:INDUSTRIAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHADE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-707-0485
Mailing Address - Street 1:100 E LEHIGH AVE
Mailing Address - Street 2:MAB SUITE L06
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1012
Mailing Address - Country:US
Mailing Address - Phone:215-707-0485
Mailing Address - Fax:215-707-0498
Practice Address - Street 1:100 E LEHIGH AVE
Practice Address - Street 2:MAB SUITE L06
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1012
Practice Address - Country:US
Practice Address - Phone:215-707-0485
Practice Address - Fax:215-707-0498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0337703000OtherHMO ID