MEDICARE: THE NEMOURS FOUNDATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	231H00000X	Audiologist
2	261QG0250X	Genetics Clinic/Center
3	2080P0006X	Developmental - Behavioral Pediatrics Physician
4	261QM2500X	Medical Specialty Clinic/Center
5	261QM0855X	Adolescent and Children Mental Health Clinic/Center
6	261QR0200X	Radiology Clinic/Center
7	261QX0200X	Oncology Clinic/Center
8	133V00000X	Registered Dietitian
9	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
10	261QH0700X	Hearing and Speech Clinic/Center
11	261QP2300X	Primary Care Clinic/Center
12	261QD1600X	Developmental Disabilities Clinic/Center
13	261QM1300X	Multi-Specialty Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	075307	OTHER	PA	MEDICARE GROUP NUMBER

Other Identifiers

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

General Provider Information

NPI Number	:	1902959653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NEMOURS FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 404112
Second Line	:	C/O MANAGED CARE
City	:	ATLANTA
State	:	GA
Zip	:	30384-4112
Country	:	US
Telephone Number	:	904-390-3610
Fax Number	:	904-697-5630

Provider Business Practice Location Address
First Line	:	833 CHESTNUT ST STE 301
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4405
Country	:	US
Telephone Number	:	215-955-5800
Fax Number	:	302-651-4549

Authorized Official
Title or Position	:	EVP, COO
Name	:	MR. MARK MUMFORD
Credential	:
Telephone Number	:	302-651-6890

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	01/21/2026

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Directions to “THE NEMOURS FOUNDATION ” Practice Location

Language	Start Address	Practice Location

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