Provider Demographics
NPI:1255884177
Name:SEAFORD HEALTH SERVICES LLC
Entity type:Organization
Organization Name:SEAFORD HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:R.PH / MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DHAMODIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-362-9297
Mailing Address - Street 1:22948 SUSSEX HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-5861
Mailing Address - Country:US
Mailing Address - Phone:302-536-7675
Mailing Address - Fax:
Practice Address - Street 1:22948 SUSSEX HWY
Practice Address - Street 2:STE 102
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5861
Practice Address - Country:US
Practice Address - Phone:302-362-9297
Practice Address - Fax:302-404-5982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2162301OtherPK