Provider Demographics
NPI:1417019597
Name:PLANNED PARENTHOOD OF DELAWARE
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF DELAWARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MA
Authorized Official - Phone:302-655-7296
Mailing Address - Street 1:625 N SHIPLEY ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-2228
Mailing Address - Country:US
Mailing Address - Phone:302-655-7296
Mailing Address - Fax:302-655-1907
Practice Address - Street 1:625 N SHIPLEY ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2228
Practice Address - Country:US
Practice Address - Phone:302-655-7296
Practice Address - Fax:302-655-1907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000935207Medicaid
DEG00017Medicare ID - Type Unspecified