Healthcare Provider Details

I. General information

NPI: 1639360860
Provider Name (Legal Business Name): OCCUPATIENT MEDICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 FRIST BOULEVARD SUITE 306
HERMITAGE TN
37076
US

IV. Provider business mailing address

5651 FRIST BOULEVARD SUITE 306
HERMITAGE TN
37076
US

V. Phone/Fax

Practice location:
  • Phone: 615-316-0100
  • Fax: 615-872-0088
Mailing address:
  • Phone: 615-316-0100
  • Fax: 615-872-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD19042
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD19042
License Number StateTN

VIII. Authorized Official

Name: DR. RENATA ELIZABETH BLUHM
Title or Position: PRESIDENT
Credential: MD, PHD
Phone: 615-316-0100