Provider Demographics
NPI:1215975149
Name:CHRISTIANA CARE HEALTH SERVICES INC.
Entity type:Organization
Organization Name:CHRISTIANA CARE HEALTH SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCMURRAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:302-428-2522
Mailing Address - Street 1:PO BOX 30170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-7170
Mailing Address - Country:US
Mailing Address - Phone:302-623-7362
Mailing Address - Fax:302-623-7374
Practice Address - Street 1:3301 LANCASTER AVENUE
Practice Address - Street 2:SUITE 9
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2907
Practice Address - Country:US
Practice Address - Phone:302-838-5297
Practice Address - Fax:302-656-5270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIANA CARE HEALTH SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1215975149Medicaid
DEG02296Medicare PIN