Provider Demographics
NPI: | 1982778270 |
---|---|
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: | 200 HYGEIA DR STE 2300 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEWARK |
Mailing Address - State: | DE |
Mailing Address - Zip Code: | 19713-2049 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 302-623-7362 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4755 OGLETOWN STANTON RD STE 6E34 |
Practice Address - Street 2: | |
Practice Address - City: | NEWARK |
Practice Address - State: | DE |
Practice Address - Zip Code: | 19718-2049 |
Practice Address - Country: | US |
Practice Address - Phone: | 302-733-4186 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | CHRISTIANA CARE HEATLH SERVICES, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-11-20 |
Last Update Date: | 2021-12-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty | |
No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
No | 207QH0002X | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RH0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207ZC0006X | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology | Group - Multi-Specialty |
No | 207ZC0500X | Allopathic & Osteopathic Physicians | Pathology | Cytopathology | Group - Multi-Specialty |
No | 207ZP0101X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | Group - Multi-Specialty |
No | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | Group - Multi-Specialty |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
DE | 1982778270 | Medicaid | |
DE | G02450 | Medicare PIN |