Provider Demographics
NPI:1427404912
Name:THE NEMOURS FOUNDATION
Entity Type:Organization
Organization Name:THE NEMOURS FOUNDATION
Other - Org Name:NEMOURS DUPONT PEDIATRICS URGENT CARE, GLEN MILLS
Other - Org Type:Other Name
Authorized Official - Title/Position:SR. VP AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCKENDREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-697-5628
Mailing Address - Street 1:PO BOX 404112
Mailing Address - Street 2:C/O MANAGED CARE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-4112
Mailing Address - Country:US
Mailing Address - Phone:904-390-3610
Mailing Address - Fax:904-697-5630
Practice Address - Street 1:101 APPLIED BANK BLVD
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-3501
Practice Address - Country:US
Practice Address - Phone:484-800-8630
Practice Address - Fax:484-800-8635
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE NEMOURS FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-13
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care