Healthcare Provider Details

I. General information

NPI: 1831641141
Provider Name (Legal Business Name): DELAWARE DME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2016
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

756 S LITTLE CREEK RD
DOVER DE
19901-4720
US

IV. Provider business mailing address

PO BOX 1165
MIDDLETOWN DE
19709-7165
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-8070
  • Fax: 302-595-3149
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MARIAM FOUZIA
Title or Position: MANAGING MEMBER
Credential:
Phone: 302-645-8070