Provider Demographics
NPI:1770807141
Name:OCCUPATIONAL HEALTH CENTERS OF NORTH CAROLINA, PC
Entity type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTERS OF NORTH CAROLINA, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP/CHIEF OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-364-8000
Mailing Address - Street 1:PO BOX 82730
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-0730
Mailing Address - Country:US
Mailing Address - Phone:800-686-0468
Mailing Address - Fax:214-775-4502
Practice Address - Street 1:4104 SURLES COURTS SUITE 11
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703
Practice Address - Country:US
Practice Address - Phone:919-941-1911
Practice Address - Fax:217-775-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine