Healthcare Provider Details

I. General information

NPI: 1063877603
Provider Name (Legal Business Name): CHRISTIANA CARE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2015
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 WILMINGTON W CHESTER PIKE CHRISTIANA CARE CONCORD HEALTH CENTER
CHADDS FORD PA
19317-9041
US

IV. Provider business mailing address

200 HYGEIA DR SUITE 2300
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 610-361-1030
  • Fax:
Mailing address:
  • Phone: 302-623-7362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

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