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General NPI Number Information
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NPI Number | 1396806162
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Entity Type | Organization
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Legal Business Name | CHRISTIAN CARE HEALTH SERVICES RIVERSIDE PHCY
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 501 W 14TH ST
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City | WILMINGTON
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State | DE
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Zip | 19801-1013
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Country | US
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Telephone | 302-428-2736
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Fax | 302-428-2469
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Provider Business Mailing Address
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Address Line | 501 W 14TH ST
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City | WILMINGTON
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State | DE
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Zip | 19801-1013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHCY MGR
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Name | ROBERT THORTON
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Credential | RPH
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Telephone | 302-428-2533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | A60000248
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License Number State | DE
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