MEDICARE: CHRISTIANA CARE HEALTH SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396715736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIANA CARE HEALTH SERVICES INC.

Provider Business Mailing Address
First Line	:	PO BOX 2653
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-0653
Country	:	US
Telephone Number	:	302-623-7200
Fax Number	:	302-623-7374

Provider Business Practice Location Address
First Line	:	501 WEST 14TH STREET
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19899
Country	:	US
Telephone Number	:	302-733-5600
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	ROBERT W MCMURRAY JR.
Credential	:
Telephone Number	:	302-428-2522

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	12/17/2021

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1720176985 — DR. KELLY MCNELIS PHARMD
Practice Location Address:

14TH AND WASHINGTON STREETS , CHRISTIANA CARE HEALTH SERVICES-WILMINGTON HOSP ANNEX
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Practice Phone: 302-255-1312
Practice Fax: 302-255-1374

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