Healthcare Provider Details

I. General information

NPI: 1457987521
Provider Name (Legal Business Name): DELAWARE RIVER MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E MAIN ST
PORT JERVIS NY
12771-2253
US

IV. Provider business mailing address

1602 AVENUE Q
LUBBOCK TX
79401-4732
US

V. Phone/Fax

Practice location:
  • Phone: 888-264-0330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: HARRY K SHEETS
Title or Position: OWNER/ PRESIDENT
Credential: MD
Phone: 806-729-3445