MEDICARE: CHRISTIANA CARE HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	363LP0200X	Pediatric Nurse Practitioner
3	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174508527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIANA CARE HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	200 HYGEIA DR STE 2300
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19713-2049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4735 OGLETOWN STANTON RD STE 1116
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19713-2089
Country	:	US
Telephone Number	:	302-368-8612
Fax Number	:	302-368-4384

Authorized Official
Title or Position	:	CFO
Name	:	ROBERT W MCMURRAY JR.
Credential	:
Telephone Number	:	302-428-2522

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	02/23/2022

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