Provider Demographics
NPI:1588614762
Name:GLASGOW MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:GLASGOW MEDICAL CENTER, LLC
Other - Org Name:MIDDLETOWN MEDICAL AID UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:C
Authorized Official - Last Name:KRETZ
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:302-836-8350
Mailing Address - Street 1:2600 GLASGOW AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4777
Mailing Address - Country:US
Mailing Address - Phone:302-836-8350
Mailing Address - Fax:302-836-1906
Practice Address - Street 1:124 SLEEPY HOLLOW DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8894
Practice Address - Country:US
Practice Address - Phone:303-449-3100
Practice Address - Fax:302-449-3110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
252197OtherALLIANCE
6199485OtherCIGNA
1000035611OtherDE PHYS CARE
6714AOtherCOVENTRY HEALTHCARE
A10201OtherMIDATLANTIC
0395752000OtherAMERIHEALTH
2146570OtherAETNA HMO
7061209OtherAETNA NON-HMO
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