Provider Demographics
NPI:1023155702
Name:DOVER HEALTH CARE CENTER
Entity type:Organization
Organization Name:DOVER HEALTH CARE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-736-0330
Mailing Address - Street 1:212 SOUTH QUEEN STREET
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904
Mailing Address - Country:US
Mailing Address - Phone:302-736-0330
Mailing Address - Fax:302-736-0380
Practice Address - Street 1:212 SOUTH QUEEN STREET
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904
Practice Address - Country:US
Practice Address - Phone:302-736-0330
Practice Address - Fax:302-736-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1989080646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1989080646OtherBUSINESS LICENSE