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Contract Details
Occupational Health Centers of the Southwest, P.A.
Facility name
Concentra Medical Center
Provider ID
P000002887
NPI
1396879409
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
3488 Goni Road Building E, Suite 141
Carson City, NV 89701
United States
County
Carson City
Phone
7758875030
(
Phone
)
Billing Details
Address
PO Box 9010
Broomfield, CO 80021
Billing Phone
8008588599
Specialty Type
Occupational Medicine Facility
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Address