Provider Demographics
NPI:1932243375
Name:IMMEDIATE CARE CENTERS OF DELAWARE
Entity Type:Organization
Organization Name:IMMEDIATE CARE CENTERS OF DELAWARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:B
Authorized Official - Last Name:KILLEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-749-3142
Mailing Address - Street 1:PO BOX 3460
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-3460
Mailing Address - Country:US
Mailing Address - Phone:410-749-3142
Mailing Address - Fax:410-749-7267
Practice Address - Street 1:1535 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1611
Practice Address - Country:US
Practice Address - Phone:410-749-3142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty