Provider Demographics
NPI:1659443257
Name:CLAYMONT FAMILY HEALTH SERVICES
Entity Type:Organization
Organization Name:CLAYMONT FAMILY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL SERVICES COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:CROPPER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:302-798-9755
Mailing Address - Street 1:3301 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2052
Mailing Address - Country:US
Mailing Address - Phone:302-798-9755
Mailing Address - Fax:302-792-2712
Practice Address - Street 1:3301 GREEN ST
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2052
Practice Address - Country:US
Practice Address - Phone:302-798-9755
Practice Address - Fax:302-792-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECL0071261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center