Organization · Type 2 NPI

Southbridge Medical Advisory Council Inc

Federally Qualified Health Center (FQHC) · Wilmington, DE

NPI number 1639417280 Active

Practice location

600 N Lombard St
Wilmington, DE 19801-4429

Call (302) 761-4610 Map

Fax (302) 655-6606

Mailing address

601 New Castle Ave
Wilmington, DE 19801-5821

Specialties and licenses

Taxonomy	Code	License
Dentist	122300000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

State of DelawareLocal Education Agency (LEA) Wilmington, DE NPI 1750425625

Other federally qualified health center (fqhc) providers in Wilmington

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NPI record

NPI: 1639417280
Entity type: Organization (Type 2)
Issued: Jan 16, 2013
Last updated: Jan 16, 2013
Status: Active
Subpart: Yes of Southbridge Medical Advisory Council Inc

Other names

<unavail>
Henrietta Johnson Medical Center · doing business as

Authorized official

Ms. Rosa Rivera
Chief Executive Officer
(302) 427-9696

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639417280

Southbridge Medical Advisory Council Inc's National Provider Identifier is 1639417280, issued on Jan 16, 2013. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Wilmington, DE. The record was last updated on Jan 16, 2013.