Provider Demographics
NPI:1831398734
Name:VOCATIONAL MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:VOCATIONAL MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOLOTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-505-9776
Mailing Address - Street 1:2302 TIBBETTS WICK RD
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-1231
Mailing Address - Country:US
Mailing Address - Phone:330-505-9776
Mailing Address - Fax:330-505-9770
Practice Address - Street 1:2302 TIBBETTS WICK RD
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-1231
Practice Address - Country:US
Practice Address - Phone:330-505-9776
Practice Address - Fax:330-505-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35060979207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0858433Medicaid
1457336497OtherNPI #
OH0858433Medicaid
F47365Medicare UPIN