Provider Demographics
NPI:1619006590
Name:CHRISTIANA CARE-ROCKWOOD PHYSICIANS, PA
Entity Type:Organization
Organization Name:CHRISTIANA CARE-ROCKWOOD PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ECCLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-529-1975
Mailing Address - Street 1:2002 FOULK RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3643
Mailing Address - Country:US
Mailing Address - Phone:302-529-1975
Mailing Address - Fax:302-529-1763
Practice Address - Street 1:2002 FOULK RD
Practice Address - Street 2:SUITE C & D
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3643
Practice Address - Country:US
Practice Address - Phone:302-529-1975
Practice Address - Fax:302-529-1763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEH67692Medicare UPIN