Healthcare Provider Details
I. General information
NPI: 1487494662
Provider Name (Legal Business Name): CHRISTIANA CARE PENNSYLVANIA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
161 WILMINGTON W CHESTER PIKE
CHADDS FORD PA
19317-9041
US
IV. Provider business mailing address
4000 NEXUS DR STE E3
WILMINGTON DE
19803-3000
US
V. Phone/Fax
- Phone: 610-361-1115
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0001X |
| Taxonomy | Advanced Heart Failure and Transplant Cardiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
W
MCMURRAY
JR.
Title or Position: CFO
Credential:
Phone: 302-623-7362