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Contract Details
Occupational Health Centers of the Southwest, P.A.
Facility name
Concentra Medical Center
Provider ID
P000002980
NPI
1720111834
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
1619 North Stoughton Road
Madison, WI 53704
United States
County
Dane
Phone
6082441213
(
Phone
)
Billing Details
Address
PO Box 1297
Brookfield, WI 53008
Billing Phone
8886226331
Specialty Type
Occupational Medicine Facility
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