Healthcare Provider Details

I. General information

NPI: 1194564427
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

Practice location:
  • Phone: 610-361-1150
  • Fax:
Mailing address:
  • Phone: 302-623-7362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT W MCMURRAY JR.
Title or Position: CFO
Credential:
Phone: 302-623-7362