Provider Demographics
NPI:1740020122
Name:WORKING FOR PROGRESS LLC
Entity type:Organization
Organization Name:WORKING FOR PROGRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-948-8566
Mailing Address - Street 1:401 WINSTON AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-1818
Mailing Address - Country:US
Mailing Address - Phone:302-290-5390
Mailing Address - Fax:302-993-1029
Practice Address - Street 1:401 WINSTON AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-1818
Practice Address - Country:US
Practice Address - Phone:302-290-5390
Practice Address - Fax:302-993-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty