Healthcare Provider Details

I. General information

NPI: 1992340921
Provider Name (Legal Business Name): ASPIRA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18068 COASTAL HWY
LEWES DE
19958-4901
US

IV. Provider business mailing address

10320 WINNERS CIRCLE WAY
LAUREL MD
20723-5739
US

V. Phone/Fax

Practice location:
  • Phone: 302-567-1500
  • Fax: 302-258-0942
Mailing address:
  • Phone: 301-520-3271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RACHEL OBENSCHAIN
Title or Position: BILLING MANAGER
Credential:
Phone: 301-520-3271