Healthcare Provider Details

I. General information

NPI: 1366874828
Provider Name (Legal Business Name): CHRISTIANA CARE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

200 HYGEIA DR SUITE 2300 - PHYSICIAN CONTRACTING
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 610-361-1195
  • Fax:
Mailing address:
  • Phone: 302-623-7362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StatePA

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: 302-428-2522