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General NPI Number Information
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NPI Number | 1588071575
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Entity Type | Organization
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Legal Business Name | FOULK ROAD SURGERY CENTER
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 900 FOULK RD
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City | WILMINGTON
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State | DE
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Zip | 19803-3155
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Country | US
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Telephone | 302-777-4800
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Fax | 302-777-2111
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Provider Business Mailing Address
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Address Line | 900 FOULK RD
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City | WILMINGTON
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State | DE
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Zip | 19803-3155
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Country | US
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Telephone | 302-777-4800
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Fax | 302-777-2111
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Authorized Official
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Title or Position | SR VP OF OPERATIONS
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Name | STACEY TAYLOR
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Credential | RN
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Telephone | 781-733-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | DE
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