MEDICARE: DELAWARE FAMILY HEALTHCARE ALLIANCE, 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	261QP2300X	Primary Care Clinic/Center	2005206803	DE

General Provider Information

NPI Number	:	1437371093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELAWARE FAMILY HEALTHCARE ALLIANCE, INC.

Provider Business Mailing Address
First Line	:	2114 S DUPONT HWY STE 1
Second Line	:
City	:	CAMDEN
State	:	DE
Zip	:	19934-1249
Country	:	US
Telephone Number	:	302-697-0515
Fax Number	:	302-697-0415

Provider Business Practice Location Address
First Line	:	2114 S DUPONT HWY STE 1
Second Line	:
City	:	CAMDEN
State	:	DE
Zip	:	19934-1249
Country	:	US
Telephone Number	:	302-697-0515
Fax Number	:	302-697-0415

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SANDRA NMI PATTERSON
Credential	:	CRNP
Telephone Number	:	302-677-0515

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	02/25/2011

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