Healthcare Provider Details

I. General information

NPI: 1568734911
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH SERVICES OF DELAWARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HYGEIA DR SUITE 1175
NEWARK DE
19713-2049
US

IV. Provider business mailing address

200 HYGEIA DR SUITE 1175
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-0111
  • Fax:
Mailing address:
  • Phone: 302-623-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberJ1-0000982
License Number StateDE

VIII. Authorized Official

Name: MR. FRANKLIN JOHN ROOKS JR.
Title or Position: MEMBER
Credential: PT
Phone: 610-806-2077