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Contract Details
Occupational Health Centers of the Southwest, P.A., P.C.
Facility name
Concentra Medical Center
Provider ID
P000002740
NPI
1679608699
Tax ID
752014828
Effective Date
2/1/2012
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_135
AM_135
Location Details
Address
10 Connecticut Avenue
Norwich, CT 06360
United States
County
New London
Phone
8608595100
(
Phone
)
Billing Details
Address
PO Box 8960
Elkridge, MD 21075
Billing Phone
8888093214
Specialty Type
Occupational Medicine Facility
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