Provider Demographics
NPI:1285191494
Name:PRECISION CARE & WELLNESS, LLC
Entity Type:Organization
Organization Name:PRECISION CARE & WELLNESS, LLC
Other - Org Name:WILMINGTON 1ST WALK-IN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:ASHLEY ROANE
Authorized Official - Last Name:BURGE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:302-407-5222
Mailing Address - Street 1:4001 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-1961
Mailing Address - Country:US
Mailing Address - Phone:302-407-5222
Mailing Address - Fax:302-407-5221
Practice Address - Street 1:4001 MILLER RD STE 1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-1961
Practice Address - Country:US
Practice Address - Phone:302-407-5222
Practice Address - Fax:302-407-5221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECISION CARE AND WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-24
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1174951081Medicaid
DE250549932Medicaid
DE1629473483Medicaid