HomeMy WebLinkAboutInv# 1157350726 - CONCENTRA MEDICAL CENTERS - 11/26/2024Concerdra7
Taxld: 75-2014828
Account: N33-1242003529
Invoice: 1157350726 Balance: $29.00
INVOICE
Remit To:
Invoice Date:
Date Printed:
Occupational Health Centers
of the Southwest, P.A.
PO Box 82549
Hapeville., GA 30354-0549
(800)686-0468
11/05/2024 - 11/05/2024
11/11/2024
Bill To: City of Dania Beach Location: City of Dania Beach
Attn: Linda Gonzalez Attn: Linda Gonzalez
100 W Dania Beach Blvd 100 W Dania Beach Blvd
Dania, FL 33004-3643 Dania, FL 33004-3643
PLEASE RETURN THIS PORTION WITH YOUR REMITTANCE.
Name / SSN / Charge Charge Pmts /
Date PO Number Birth date Description Amount Adjmnts
The Following Services Performed at CMC - MIA Sawgrass
11/05/2024 Larkin, Jeffery J XXX-XX-0608 Phys w/Reg UDS Coll & BAT, DFWP
PrePl XX/XX/XXXX Regulated UDS Collect 29.00
15252522522
Balance Due: $29.00
Occupational Health Centers
Remit To:
of the Southwest, P.A.
We appreciate your business. You can
now pay online at
Account:
N33-1242003529
https://payments.concentra.com/. Online
payments must be
Inv Date:
11/05/2024 - 11/05/2024
made via credit card. Please contact
our Central Business
Office at 800-686-0468 for additional
information.
Page: 1/1
AA/EEO Employer PAYMENT DUE UPON RECEIPT