Basic Information
Provider Information
NPI: 1245474329
EntityType: 2
ReplacementNPI:  
OrganizationName: CHRISTIANA CARE HEALTH SERVICES INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CCHS HOSPITALIST PARTNERS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HYGEIA DR
Address2: SUITE 2502
City: NEWARK
State: DE
PostalCode: 197132049
CountryCode: US
TelephoneNumber: 3026237362
FaxNumber:  
Practice Location
Address1: 200 HYGEIA DR
Address2: SUITE 2100
City: NEWARK
State: DE
PostalCode: 197132049
CountryCode: US
TelephoneNumber: 3026230188
FaxNumber: 3026230117
Other Information
ProviderEnumerationDate: 04/21/2009
LastUpdateDate: 12/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MCMURRAY
AuthorizedOfficialFirstName: ROBERT
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 3024282522
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: CHRISTIANA CARE HEALTH SERVICES INC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 
207R00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 
208000000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPediatrics 
208M00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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