Healthcare Provider Details

I. General information

NPI: 1447825328
Provider Name (Legal Business Name): LONDON LOGISTICS & HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 CHRISTIANA MEDICAL CTR
NEWARK DE
19702-1653
US

IV. Provider business mailing address

51 E GARWOOD AVE
WILLIAMSTOWN NJ
08094-1601
US

V. Phone/Fax

Practice location:
  • Phone: 302-273-3926
  • Fax: 856-341-9319
Mailing address:
  • Phone: 302-273-3926
  • Fax: 856-341-9319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AISHA ADDISON
Title or Position: OWNER, AUTHORIZED OFFICIAL
Credential: FNP-BC
Phone: 302-273-3926