Healthcare Provider Details

I. General information

NPI: 1528111739
Provider Name (Legal Business Name): AIDS DELAWARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 REHOBOTH AVE
REHOBOTH BEACH DE
19971-1667
US

IV. Provider business mailing address

100 W 10TH ST SUITE 315
WILMINGTON DE
19801-6603
US

V. Phone/Fax

Practice location:
  • Phone: 302-226-5350
  • Fax: 302-226-3519
Mailing address:
  • Phone: 302-652-6776
  • Fax: 302-652-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number103TH0100N
License Number StateDE

VIII. Authorized Official

Name: MR. JOHN D. BAKER
Title or Position: EXECUTIVE DIRECTOR
Credential: MPA, CFRE
Phone: 302-652-6776