CONCENTRA MEDICAL CENTER -- CANTON – NPI #1114117447
Clinic/Center

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CONCENTRA MEDICAL CENTER -- CANTON is an AHC clinic located in CANTON, MI. NPPES has assigned the NPI number 1114117447 to CONCENTRA MEDICAL CENTER -- CANTON on August 01, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QX0100X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Occupational Medicine

The NPI profile was previously updated about 19 years ago on Aug 08, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CONCENTRA MEDICAL CENTER -- CANTON below.

NPI Profile for
CONCENTRA MEDICAL CENTER -- CANTON

NPI Number

1114117447

Enumeration Date

Aug 01, 2007
(about 19 years ago)

Entity Type

Type-2 Organization

Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.

Legal Name

CONCENTRA MEDICAL CENTER -- CANTON

Primary location

1600 S CANTON CENTER RD
SUITE 140
CANTON, MI 48188-1992

Phone: (734) 398-7550

Mailing address

PO BOX 5106
SOUTHFIELD, MI 48086-5106

Phone:

Organization Subpart

Yes - CONCENTRA MEDICAL CENTER -- CANTON is subpart of another organization.

Authorized Official

W. FOGARTY
CHIEF MEDICAL OFFIDER
Phone: (972) 364-8000

Updated

Aug 08, 2007

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization	State	License
261QX0100X - Clinic/Center / Occupational Medicine (Primary)
261QP2000X - Clinic/Center / Physical Therapy
261QH0100X - Clinic/Center / Health Service

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.