Provider Demographics
NPI:1295918498
Name:OCCUHEALTH
Entity type:Organization
Organization Name:OCCUHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGDALE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:517-291-5510
Mailing Address - Street 1:2150 W CENTRAL AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3846
Mailing Address - Country:US
Mailing Address - Phone:517-291-5517
Mailing Address - Fax:517-291-3263
Practice Address - Street 1:2150 W CENTRAL AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3846
Practice Address - Country:US
Practice Address - Phone:517-291-5517
Practice Address - Fax:517-291-3263
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TOLEDO HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty