Healthcare Provider Details

I. General information

NPI: 1467655910
Provider Name (Legal Business Name): PROGRESSIVEHEALTH OCC HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 S TULIP TREE DR
PRINCETON IN
47670-2300
US

IV. Provider business mailing address

150 N ROSENBERGER AVE
EVANSVILLE IN
47712-6503
US

V. Phone/Fax

Practice location:
  • Phone: 866-649-2678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEITH BERSCH
Title or Position: CEO
Credential:
Phone: 812-491-3856