Healthcare Provider Details

I. General information

NPI: 1659443257
Provider Name (Legal Business Name): CLAYMONT FAMILY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 GREEN ST
CLAYMONT DE
19703-2052
US

IV. Provider business mailing address

3301 GREEN ST
CLAYMONT DE
19703-2052
US

V. Phone/Fax

Practice location:
  • Phone: 302-798-9755
  • Fax: 302-792-2712
Mailing address:
  • Phone: 302-798-9755
  • Fax: 302-792-2712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberCL0071
License Number StateDE

VIII. Authorized Official

Name: MRS. SUSAN LESLIE CROPPER
Title or Position: MEDICAL SERVICES COORDINATOR
Credential: RN
Phone: 302-798-9755