Healthcare Provider Details

I. General information

NPI: 1053583559
Provider Name (Legal Business Name): AMBIENT MEDICAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24459 SUSSEX HWY STE 2
SEAFORD DE
19973-4425
US

IV. Provider business mailing address

PO BOX 1827
SEAFORD DE
19973-8827
US

V. Phone/Fax

Practice location:
  • Phone: 302-629-3099
  • Fax: 302-629-6059
Mailing address:
  • Phone: 302-629-3099
  • Fax: 302-629-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT ANTHONY HENRY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 302-629-3099