Provider Demographics
NPI:1629152657
Name:MCELLIGOTT, ROBERT E (CPO)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:MCELLIGOTT
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7302
Mailing Address - Country:US
Mailing Address - Phone:302-678-8311
Mailing Address - Fax:302-678-8319
Practice Address - Street 1:30 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7302
Practice Address - Country:US
Practice Address - Phone:302-678-8311
Practice Address - Fax:302-678-8319
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE5157290001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER