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General NPI Number Information
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NPI Number | 1982288601
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Entity Type | Organization
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Legal Business Name | WILMINGTON VACCINES CORPORATION
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Dates
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Enumeration Date | 05/09/2021
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Last Update Date | 08/08/2021
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Provider Practice Location Address
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Address Line | 915 N MADISON ST
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City | WILMINGTON
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State | DE
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Zip | 19801-1439
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Country | US
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Telephone | 302-803-5978
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Fax |
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Provider Business Mailing Address
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Address Line | 915 N MADISON ST LOWR GROUND
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City | WILMINGTON
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State | DE
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Zip | 19801-1439
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Country | US
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Telephone | 302-803-5978
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DAVID F AMAKOBE
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Credential | DBA
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Telephone | 302-252-7279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1000X
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Taxonomy Name | Migrant Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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