Healthcare Provider Details

I. General information

NPI: 1265847354
Provider Name (Legal Business Name): COMPASSIONATE DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MIDWAY DR SUITE 3
HARRINGTON DE
19952-2448
US

IV. Provider business mailing address

1000 MIDWAY DR SUITE 3
HARRINGTON DE
19952-2448
US

V. Phone/Fax

Practice location:
  • Phone: 302-398-0888
  • Fax: 302-398-0889
Mailing address:
  • Phone: 302-398-0888
  • Fax: 302-398-0889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC1-0006413
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License NumberC1-0006413
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License NumberC1-0006413
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberC1-0006413
License Number StateDE

VIII. Authorized Official

Name: DR. EVA CAROL DICKINSON
Title or Position: OWNER
Credential: MD PHD
Phone: 410-829-5580