Healthcare Provider Details

I. General information

NPI: 1780462374
Provider Name (Legal Business Name): RHEUMATOLOGY AND FIBROMYALGIA CENTER OF EXCELLENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 E MAIN ST
MIDDLETOWN DE
19709-1494
US

IV. Provider business mailing address

29 E MAIN ST
MIDDLETOWN DE
19709-1494
US

V. Phone/Fax

Practice location:
  • Phone: 302-513-0550
  • Fax: 800-524-6869
Mailing address:
  • Phone: 302-513-0550
  • Fax: 800-524-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JAY W LYNCH
Title or Position: PRACTICE ADMINSTRATOR
Credential:
Phone: 302-660-1100