Healthcare Provider Details

I. General information

NPI: 1972645653
Provider Name (Legal Business Name): DELMARVA RURAL MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/03/2007
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 TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

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