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	License Number	License Number State
1	207RR0500X	Rheumatology Physician		DE

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	:	1215975149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIANA CARE HEALTH SERVICES INC.

Provider Business Mailing Address
First Line	:	PO BOX 30170
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-7170
Country	:	US
Telephone Number	:	302-623-7362
Fax Number	:	302-623-7374

Provider Business Practice Location Address
First Line	:	3301 LANCASTER AVENUE
Second Line	:	SUITE 9
City	:	WILMINGTON
State	:	DE
Zip	:	19805-2907
Country	:	US
Telephone Number	:	302-838-5297
Fax Number	:	302-656-5270

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	12/17/2021

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