Contract Details
Occupational Health Centers of the Southwest, P.A., P.C.
Facility name
Concentra Medical Center
Provider ID
P000002975
NPI
1053613166
Tax ID
752014828
Effective Date
2/1/2012
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_135
Location Details
Address
9900 West Broad Street Suite C
Glen Allen, VA 23060
United States
County
Henrico
Phone
8043580361 (Phone)
Billing Details
Address
PO Box 18277
Baltimore, MD 21227
Billing Phone
8888092214
Specialty Type
Occupational Medicine Facility
Map
Address