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General NPI Number Information
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NPI Number | 1154946101
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Entity Type | Organization
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Legal Business Name | STATE DRUG TESTING & OCCUPATIONAL HEALTH, INC.
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 24 W CHATHAM CT
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City | GARDEN CITY
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State | GA
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Zip | 31408-3051
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Country | US
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Telephone | 912-446-1777
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18240
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City | GARDEN CITY
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State | GA
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Zip | 31418-0240
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Country | US
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Telephone | 912-446-1777
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VP
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Name | JEAN H SIMMONS
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Credential |
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Telephone | 912-446-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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