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General NPI Number Information
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NPI Number | 1811064959
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Entity Type | Organization
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Legal Business Name | RIDGAWAY PHILIPS OF DE, INC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 908 CHURCHMANS ROAD EXT SUITE B
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City | NEW CASTLE
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State | DE
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Zip | 19720-3109
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Country | US
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Telephone | 302-323-1436
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Fax | 302-323-1481
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Provider Business Mailing Address
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Address Line | 908 CHURCHMANS ROAD EXT SUITE B
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City | NEW CASTLE
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State | DE
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Zip | 19720-3109
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Country | US
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Telephone | 302-323-1436
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Fax | 302-323-1481
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JACQUELINE S MOORE
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Credential |
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Telephone | 215-643-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2003109630
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License Number State | DE
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