Provider Demographics
NPI:1902089493
Name:OCCUPATIONAL HEALTH CENTERS OF KANSAS PA
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTERS OF KANSAS PA
Other - Org Name:CONCENTRA MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIPORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-364-8000
Mailing Address - Street 1:1617 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-3839
Mailing Address - Country:US
Mailing Address - Phone:314-421-2557
Mailing Address - Fax:314-421-2046
Practice Address - Street 1:1617 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-3839
Practice Address - Country:US
Practice Address - Phone:314-421-2557
Practice Address - Fax:314-421-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO752014828302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization