Healthcare Provider Details

I. General information

NPI: 1851338677
Provider Name (Legal Business Name): DELAWARE SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING ST SUITE 110
DOVER DE
19904-3485
US

IV. Provider business mailing address

200 BANNING ST SUITE 110
DOVER DE
19904-3485
US

V. Phone/Fax

Practice location:
  • Phone: 302-346-4000
  • Fax: 302-741-0451
Mailing address:
  • Phone: 302-346-4000
  • Fax: 302-741-0451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberFSSC-009
License Number StateDE

VIII. Authorized Official

Name: JENNIFER ANDERSON
Title or Position: CEO
Credential:
Phone: 302-736-3710