Healthcare Provider Details

I. General information

NPI: 1003652496
Provider Name (Legal Business Name): POMONA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BROWNING CIR
MIDDLETOWN DE
19709-1662
US

IV. Provider business mailing address

25 BROWNING CIR
MIDDLETOWN DE
19709-1662
US

V. Phone/Fax

Practice location:
  • Phone: 302-212-0888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: REGINA SANTANGELO
Title or Position: MANAGER
Credential: RD, LDN
Phone: 302-384-5836