Provider Demographics
NPI:1578726857
Name:DELAWARE COUNTY JUVENILE DETENTION CENTER FAMILY PLANNING
Entity Type:Organization
Organization Name:DELAWARE COUNTY JUVENILE DETENTION CENTER FAMILY PLANNING
Other - Org Name:LIMA DETENTION CENTER FAMILY PLANNING
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DRU
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-447-2271
Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:PEARL HALL
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-447-2271
Mailing Address - Fax:610-447-2215
Practice Address - Street 1:370 N MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5505
Practice Address - Country:US
Practice Address - Phone:610-891-8674
Practice Address - Fax:610-892-8468
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH ACCESS NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-07
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA037201261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007474470127Medicaid