Provider Demographics
NPI:1932553401
Name:SEASCAPE HEALTH ALLIANCE
Entity Type:Organization
Organization Name:SEASCAPE HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COVERDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-491-4258
Mailing Address - Street 1:628 MILFORD HARRINGTON HWY
Mailing Address - Street 2:STE 5
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-5370
Mailing Address - Country:US
Mailing Address - Phone:302-491-4258
Mailing Address - Fax:302-491-4398
Practice Address - Street 1:628 MILFORD HARRINGTON HWY
Practice Address - Street 2:STE 5
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-5370
Practice Address - Country:US
Practice Address - Phone:302-491-4258
Practice Address - Fax:302-491-4398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE08D2110667291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory