Healthcare Provider Details

I. General information

NPI: 1255745899
Provider Name (Legal Business Name): CENTER FOR OCCUPATIONAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 06/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8323 E MARKET ST
WARREN OH
44484-2342
US

IV. Provider business mailing address

8323 E MARKET ST
WARREN OH
44484-2342
US

V. Phone/Fax

Practice location:
  • Phone: 330-609-5533
  • Fax: 330-609-5553
Mailing address:
  • Phone: 330-609-5533
  • Fax: 330-609-5553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number2287477
License Number StateOH

VIII. Authorized Official

Name: DR. CHRIS EFTHIMIOU
Title or Position: OPERATOR
Credential: DC
Phone: 330-609-5533