Healthcare Provider Details

I. General information

NPI: 1659629988
Provider Name (Legal Business Name): CHRISTIANA CARE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W 14TH ST HOSPITAL DENTISTRY, WILMINGTON HOSPITAL
WILMINGTON DE
19801-1013
US

IV. Provider business mailing address

200 HYGEIA DR SUITE 2300
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-428-4850
  • Fax:
Mailing address:
  • Phone: 302-623-7362
  • Fax: 302-623-7397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT W MCMURRAY JR.
Title or Position: CFO
Credential:
Phone: 302-428-2522