Healthcare Provider Details

I. General information

NPI: 1689055345
Provider Name (Legal Business Name): THE ROSA HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N FRONT ST
GEORGETOWN DE
19947-1414
US

IV. Provider business mailing address

10 N FRONT ST
GEORGETOWN DE
19947-1414
US

V. Phone/Fax

Practice location:
  • Phone: 302-858-4381
  • Fax: 302-644-0717
Mailing address:
  • Phone: 302-858-4381
  • Fax: 302-644-0717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2014102910361
License Number StateDE

VIII. Authorized Official

Name: DR. RAMA DASIKA PERI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 302-858-4381