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NPI Code Detail

MEDICARE: CARROLL OCCUPATIONAL HEALTH, LLC

MEDICARE: CARROLL OCCUPATIONAL HEALTH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QC1800XCorporate Health Clinic/Center
2261QP2000XPhysical Therapy Clinic/Center
3261QX0100XOccupational Medicine Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10OTHERNOT APPLICABLE

General Provider Information

NPI Number : 1568064079
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARROLL OCCUPATIONAL HEALTH, LLC
Provider Business Mailing Address
First Line : PO BOX 37581
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3581
Country : US
Telephone Number : 240-566-3011
Fax Number : 240-566-3171
Provider Business Practice Location Address
First Line : 700B CORPORATE CENTER CT STE A
Second Line :
City : WESTMINSTER
State : MD
Zip : 21157-3035
Country : US
Telephone Number : 410-871-0470
Fax Number : 410-871-0743
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : MRS. LISA DEGITZ
Credential :
Telephone Number : 240-566-3258
Provider Enumeration Date : 11/10/2020
Last Update Date : 11/10/2020

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Directions to “CARROLL OCCUPATIONAL HEALTH, LLC ” Practice Location

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