Provider Demographics
NPI:1205885746
Name:GLASGOW MEDICAL CENTER LLC
Entity type:Organization
Organization Name:GLASGOW MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RN
Authorized Official - Phone:302-836-3539
Mailing Address - Street 1:2600 GLASGOW AVE STE 226
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5709
Mailing Address - Country:US
Mailing Address - Phone:302-836-8350
Mailing Address - Fax:302-355-3972
Practice Address - Street 1:2600 GLASGOW AVE STE 226
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5709
Practice Address - Country:US
Practice Address - Phone:302-836-3539
Practice Address - Fax:302-355-3972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEFSSC 003261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
165981OtherBCBSDE PROVIDER #
0094313OtherAETNA
490003207OtherRAILROAD MEDICARE
73291OtherCOVENTRY HEALTHCARE
9846333OtherCIGNA
249428OtherALLIANCE
144788800OtherOWCP
0004763000OtherAMERIHEALTH