MEDICARE: INGLESIDE HOMES, 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	376J00000X	Homemaker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A000000237	OTHER	DE	DMAP STATE OF DELAWARE

General Provider Information

NPI Number	:	1447594049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INGLESIDE HOMES, INC

Provider Business Mailing Address
First Line	:	1005 N FRANKLIN ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4553
Country	:	US
Telephone Number	:	302-575-0250
Fax Number	:	302-575-9955

Provider Business Practice Location Address
First Line	:	1005 N FRANKLIN ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4553
Country	:	US
Telephone Number	:	302-575-0250
Fax Number	:	302-575-9955

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MS. SUSAN JONAS
Credential	:
Telephone Number	:	302-575-0250

Provider Enumeration Date	:	11/20/2012
Last Update Date	:	01/04/2024

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Directions to “INGLESIDE HOMES, INC ” Practice Location

Language	Start Address	Practice Location

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