Healthcare Provider Details

I. General information

NPI: 1114744810
Provider Name (Legal Business Name): MOBILE-MED WORK HEALTH SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 E SHELBY DR
MEMPHIS TN
38118-7506
US

IV. Provider business mailing address

2101 FOREST AVE STE 220A
SAN JOSE CA
95128-1473
US

V. Phone/Fax

Practice location:
  • Phone: 877-899-9959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEAN FRIEDERS
Title or Position: CHIEF SOLUTIONS OFFICER
Credential:
Phone: 630-292-4023