Provider Demographics
| NPI: | 1902959653 |
|---|---|
| Name: | THE NEMOURS FOUNDATION |
| Entity type: | Organization |
| Organization Name: | THE NEMOURS FOUNDATION |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VP, FINANCE |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | RODNEY |
| Authorized Official - Middle Name: | A |
| Authorized Official - Last Name: | MCKENDREE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 904-697-5628 |
| Mailing Address - Street 1: | PO BOX 404112 |
| Mailing Address - Street 2: | C/O MANAGED CARE |
| Mailing Address - City: | ATLANTA |
| Mailing Address - State: | GA |
| Mailing Address - Zip Code: | 30384-4112 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 904-390-3610 |
| Mailing Address - Fax: | 904-697-5630 |
| Practice Address - Street 1: | 833 CHESTNUT ST |
| Practice Address - Street 2: | SUITE 300 |
| Practice Address - City: | PHILADELPHIA |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 19107-4414 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 215-955-5800 |
| Practice Address - Fax: | 302-651-4549 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | THE NEMOURS FOUNDATION |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2007-01-18 |
| Last Update Date: | 2021-07-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261QX0200X | Ambulatory Health Care Facilities | Clinic/Center | Oncology | Group - Multi-Specialty |
| No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | Group - Multi-Specialty |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | Group - Multi-Specialty |
| No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty | |
| No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | |
| No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology | |
| No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | |
| No | 261QE0700X | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment | Group - Multi-Specialty |
| No | 261QG0250X | Ambulatory Health Care Facilities | Clinic/Center | Genetics | Group - Multi-Specialty |
| No | 2080P0006X | Allopathic & Osteopathic Physicians | Pediatrics | Developmental - Behavioral Pediatrics | Group - Multi-Specialty |
| No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 075307 | Other | MEDICARE GROUP NUMBER |
| PA | 1007434570020 | Medicaid |
