Healthcare Provider Details
I. General information
NPI: 1134968456
Provider Name (Legal Business Name): CHRISTIANA CARE PENNSYLVANIA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2024
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
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: 610-361-1170
- Fax:
- Phone: 302-623-7362
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ROBERT
W
MCMURRAY
JR.
Title or Position: CFO
Credential:
Phone: 302-623-7362