Healthcare Provider Details

I. General information

NPI: 1174774517
Provider Name (Legal Business Name): OCCUPATIONAL MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 10/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4807 BENSON AVE
BALTIMORE MD
21227-1530
US

IV. Provider business mailing address

4807 BENSON AVE
BALTIMORE MD
21227-1530
US

V. Phone/Fax

Practice location:
  • Phone: 443-524-2737
  • Fax: 443-524-2741
Mailing address:
  • Phone: 443-524-2737
  • Fax: 443-524-2741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateMD

VIII. Authorized Official

Name: MR. WILL PHILLIPS
Title or Position: CHEIF OPERATING OFFICER
Credential: C.O.O.
Phone: 443-524-2737