Provider Demographics
NPI:1497175269
Name:MID ATLANTIC CARE
Entity Type:Organization
Organization Name:MID ATLANTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YOUSIF
Authorized Official - Middle Name:A
Authorized Official - Last Name:OMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-744-3830
Mailing Address - Street 1:15 PRESTBURY SQ STE 4
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2608
Mailing Address - Country:US
Mailing Address - Phone:302-266-8306
Mailing Address - Fax:302-266-9306
Practice Address - Street 1:15 PRESTBURY SQ STE 4
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2608
Practice Address - Country:US
Practice Address - Phone:302-266-8306
Practice Address - Fax:302-266-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance