Healthcare Provider Details

I. General information

NPI: 1528100070
Provider Name (Legal Business Name): DELMARVA RURAL MINISTRIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 S BRADFORD ST
DOVER DE
19904-4141
US

IV. Provider business mailing address

26 WYOMING AVE
DOVER DE
19904-6922
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-2000
  • Fax: 302-346-0181
Mailing address:
  • Phone: 302-678-3652
  • Fax: 302-678-0545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MS. LOU ANN VANDERWENDE
Title or Position: PATIENT ACCOUNT COORDINATOR
Credential:
Phone: 302-678-3652