Provider Demographics
NPI:1578694626
Name:CHRISTIANACAREHEALTHSERVICES
Entity Type:Organization
Organization Name:CHRISTIANACAREHEALTHSERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIANASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICIANASSISTANT
Authorized Official - Phone:6
Mailing Address - Street 1:30 GARVEY LN
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-6302
Mailing Address - Country:US
Mailing Address - Phone:302-731-7449
Mailing Address - Fax:
Practice Address - Street 1:30 GARVEY LN
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-6302
Practice Address - Country:US
Practice Address - Phone:302-731-7449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000112282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital