Provider Demographics
NPI:1013910926
Name:CHRISTIANA CARE HEALTH SYSTEMS/VNA/HOME MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:CHRISTIANA CARE HEALTH SYSTEMS/VNA/HOME MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROTENBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-452-2930
Mailing Address - Street 1:210 EXECUTIVE DR
Mailing Address - Street 2:STE 7
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3335
Mailing Address - Country:US
Mailing Address - Phone:302-452-2941
Mailing Address - Fax:302-452-2968
Practice Address - Street 1:210 EXECUTIVE DR
Practice Address - Street 2:STE 7
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3335
Practice Address - Country:US
Practice Address - Phone:302-452-2941
Practice Address - Fax:302-452-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1996106974332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1108940001Medicare ID - Type UnspecifiedREGION A MCARE PROVIDER #