HomeMy WebLinkAboutInv# 663897269 - CONCENTRA MEDICAL CENTERS - 04/06/2023Concen{tre
Tax ld: 15-2014828Account NO5-0180478414lnvoice: 66389:-269 Balance:
Bill To: Ciry of Dania BeachAttn: Claudia Sanchez
100 W Dania Beach BlvdDania, EL 33004-3643
PLEASE
Name /Date PO Number
INVOICE
Remit To:
Invoice Date:
Date Printed:$201.00
ssN /
Birth date
Occupational Health Centersof the Southwest, p.A.
PO Box 1,8271
Baltimore, MD 21221-021'7
(8BB) 809-3214
03/24/2023 - 03/24/2023
03/27 /2023
Location: City of Dania BeachAttn: Claudia Sanchez
100 W Dania Beach BlvdDania, FL 33004-3643
RETURN THIS PORTION WITH YOUR REMITTANCE.
Charge
Description
Charge
Amount
Pmts /
Adjmnts
The Folfowing Services performed at cMC - BAL-Gaithersburg
03/24/2023 Barrientos, Adelyprepl XXX-XX- phys w/Non Reg UDS 10 pn1
XX,/XXIXXXX Non Regulated UDS 10 panel 2jgOOphysical Exam Concentra Standard
201.00
Balance Due:$201.00
Remit To:
Account:
lnv Date:
Occupational Health Centersof the Southwest, p.A.
N05-0180478414
03/24/2023 - 03/24/2023
We appreciate your business. you can now pay online athttps://payments.concentra.com/. Online payments must bemade via credit card. please contact our central BusinessOffice at the number above for additional information.
AA,/EEO EmPloyer PAYMENT DUE UPON RECEIPT
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