Healthcare Provider Details
I. General information
NPI: 1245501907
Provider Name (Legal Business Name): CARITAS HEALTHCARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2012
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 N WEST ST SUITE 1200
WILMINGTON DE
19801-1050
US
IV. Provider business mailing address
514 FRANK ORCHARDS LN
NEW CASTLE DE
19720-8731
US
V. Phone/Fax
- Phone: 302-415-2267
- Fax:
- Phone: 302-415-2267
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | DE |
VIII. Authorized Official
Name: DR.
ERNEST
MENYONGA
IGWACHO
Title or Position: PRESIDENT
Credential:
Phone: 302-415-2267