Provider Demographics
NPI:1851796916
Name:CAMDEN PRIMARY CARE L.L.C.
Entity Type:Organization
Organization Name:CAMDEN PRIMARY CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:302-698-1100
Mailing Address - Street 1:4601 S DUPONT HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-6405
Mailing Address - Country:US
Mailing Address - Phone:302-698-1100
Mailing Address - Fax:
Practice Address - Street 1:4601 S DUPONT HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-6405
Practice Address - Country:US
Practice Address - Phone:302-698-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2014606439261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care