Provider Demographics
NPI:1720182835
Name:LIMESTONE MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:LIMESTONE MEDICAL CENTER, LLC
Other - Org Name:LIMESTONE AMBULATORY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:JARBOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-992-0824
Mailing Address - Street 1:PO BOX 5030
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-0030
Mailing Address - Country:US
Mailing Address - Phone:302-992-9831
Mailing Address - Fax:302-992-0563
Practice Address - Street 1:1941 LIMESTONE RD STE 113
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5413
Practice Address - Country:US
Practice Address - Phone:302-992-9831
Practice Address - Fax:302-992-0563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEFSSC001261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000549128Medicaid
DE0000549128Medicaid