Provider Demographics
NPI:1366683799
Name:DARLEY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:DARLEY HEALTH SERVICES INC
Other - Org Name:DARLEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-798-0202
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-0639
Mailing Address - Country:US
Mailing Address - Phone:302-798-0202
Mailing Address - Fax:302-793-1827
Practice Address - Street 1:111 DARLEY RD
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2723
Practice Address - Country:US
Practice Address - Phone:302-798-0202
Practice Address - Fax:302-793-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
DEA3-00008993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1366683799Medicaid
0845000OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6210350001Medicare NSC