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NPI Code Detail

MEDICARE: WESTSIDE FAMILY HEALTHCARE, INC.

MEDICARE: WESTSIDE FAMILY HEALTHCARE, 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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

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

General Provider Information

NPI Number : 1669479929
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTSIDE FAMILY HEALTHCARE, INC.
Provider Business Mailing Address
First Line : PO BOX 151
Second Line :
City : NEW CASTLE
State : DE
Zip : 19720-0151
Country : US
Telephone Number : 302-655-2822
Fax Number : 302-655-5949
Provider Business Practice Location Address
First Line : 1802 W 4TH ST
Second Line :
City : WILMINGTON
State : DE
Zip : 19805-3420
Country : US
Telephone Number : 302-655-5822
Fax Number : 302-655-5949
Authorized Official
Title or Position : PRESIDENT/CEO
Name : CHRISTOPHER FRASER
Credential : FACHE
Telephone Number : 302-584-6290
Provider Enumeration Date : 07/01/2005
Last Update Date : 05/12/2025

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Directions to “WESTSIDE FAMILY HEALTHCARE, INC. ” Practice Location

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