Provider Demographics
NPI:1083768766
Name:HOCKESSIN WALK IN MEDICAL
Entity Type:Organization
Organization Name:HOCKESSIN WALK IN MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE REP
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-235-8808
Mailing Address - Street 1:5936 LIMESTONE RD STE 301B
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8930
Mailing Address - Country:US
Mailing Address - Phone:302-235-8808
Mailing Address - Fax:302-235-8815
Practice Address - Street 1:5936 LIMESTONE RD
Practice Address - Street 2:STE 301B
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8932
Practice Address - Country:US
Practice Address - Phone:302-235-8808
Practice Address - Fax:302-235-8815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE=========OtherTAX ID NUMBER
DE=========OtherTAX ID