Healthcare Provider Details

I. General information

NPI: 1083336036
Provider Name (Legal Business Name): QUALIBRITE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N CHURCH ST STE 24371
WILMINGTON DE
19802-4447
US

IV. Provider business mailing address

2810 N CHURCH ST STE 24371
WILMINGTON DE
19802-4447
US

V. Phone/Fax

Practice location:
  • Phone: 302-485-5551
  • Fax: 800-536-1322
Mailing address:
  • Phone: 302-485-5551
  • Fax: 800-536-1322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IFE MUYIWA-OJO
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: NP
Phone: 302-485-5551