SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC. (NPI# 1760874549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760874549 |
| Entity Type | Organization |
| Organization Name | SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC. |
| Other Organization Name | HENRIETTA JOHNSON MEDICAL CENTER CLAYMONT |
| Practice Address |
2722 Philadelphia Pike Claymont DE 19703-2568 |
| Practice Telephone | 3026556187 |
| Practice Fax Number | 3027982473 |
| Mailing Telephone | 0265561873 |
| Mailing Fax Number | 0279824733 |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2019-05-21 |
| Authorized Official Name | MS. NACHET SCOTT (CEO) |
| Authorized Official Telephone | 0265930773 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DE | MEDICARE PROVIDER TRANSACTION ACCESS NUMBER | 440009 | 01 |
| Other Name | Type Code |
|---|---|
| Henrietta Johnson Medical Center Claymont | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861925042 | Southbridge Medical Advisory Council, Inc. | Clinic/Center | 1100 S Broom St, Wilmington, DE 19805-4585 | 2017-04-05 |
| Street Address |
2722 PHILADELPHIA PIKE |
| City | CLAYMONT |
| State | DE |
| Zip Code | 19703-2568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386153211 | Delaware Walk-in Medical, LLC | Clinic/Center | 2722 Philadelphia Pike, Claymont, DE 19703-2568 | 2017-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316434012 | Laura Molin | Speech-Language Pathologist | 1131 Brandywine Blvd, Wilmington, DE 19703 | 2018-04-18 |
| 1114421666 | Preferred Home Health Care & Nursing Services Inc. | Home Health | 3529-31 Philadelphia Pike, Claymont, DE 19703 | 2018-03-20 |
| 1861940280 | Suzanne Sager | Occupational Therapist | 1112 Lighthorse Lane, Claymont, DE 19703 | 2016-09-14 |
| 1548715451 | Tomaro Monique Pilgrim | Counselor | 3301 Green St Ste 235, Claymont, DE 19703 | 2016-08-20 |
| 1447541107 | Rose Mary Strab | Counselor | 8103 Governor Printz Blvd, Claymont, DE 19703 | 2011-04-28 |
| 1952884629 | Jennifer Xenakes | Clinic/Center | 1311 Brandywine Blvd, Wimington, DE 19703 | 2018-09-10 |
| 1861980054 | Tomaro's Change | Community/Behavioral Health | 3301 Green St Ste 235, Claymont, DE 19703 | 2018-04-24 |
| 1689950495 | Christine O'niell | Registered Nurse | 1000 Pennsylvania Ave, Claymont, DE 19703 | 2011-10-25 |
| 1982722617 | Alan Son Nguyen | Dentist | 3009 Philadelphia Pike, Claymont, DE 19703 | 2007-03-27 |
| 1497045868 | Michele Marie Rossi | Social Worker | 2522 Garfield Ave, Claymont, DE 19703-1006 | 2011-04-19 |
| Find all providers in zip 19703 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1780165175 | La Red Health Center, Inc. | Clinic/Center | 26089 Long Neck Road, Millsboro, DE 19966 | 2018-08-24 |
| 1922535616 | La Red Health Center, Inc | Clinic/Center | 30637 Cedar Neck Road, Ocean View, DE 19970 | 2017-05-12 |
| 1750762126 | La Red Health Center, Inc. | Clinic/Center | 21 W Clarke Ave Ste 1001, Milford, DE 19963-1840 | 2015-06-11 |
| 1700832185 | La Red Health Center Inc | Clinic/Center | 21444 Carmean Way, Georgetown, DE 19947-4572 | 2006-05-26 |
| 1669479929 | Westside Family Healthcare, Inc. | Clinic/Center | 1802 W 4th St, Wilmington, DE 19805-3420 | 2005-07-01 |
| 1790004786 | La Red Health Center, Inc. | Clinic/Center | 1057 S Bradford St, Dover, DE 19904-4141 | 2010-05-31 |
| 1497071161 | La Red Health Center, Inc. | Clinic/Center | 300 High St, Seaford, DE 19973-3940 | 2010-04-20 |
| 1821232869 | Westside Family Healthcare, Inc | Clinic/Center | 1802 W 4th St, Wilmington, DE 19805-3420 | 2009-04-21 |
| 1811171978 | La Red Health Center Inc | Clinic/Center | 21444 Carmean Way, Georgetown, DE 19947-4572 | 2007-12-26 |
| 1225163199 | Delmarva Rural Ministries, Inc. | Clinic/Center | 26 Wyoming Ave, Dover, DE 19904-6922 | 2007-02-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.