| Henrietta Johnson Medical Center | |
|
600 N Lombard St Wilmington DE 19801-4429 | |
| (302) 761-4610 | |
| (302) 655-6606 |
| Full Name | Henrietta Johnson Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 N Lombard St, Wilmington, Delaware |
| Authorized Official Name and Position | Rosa Rivera (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3024279696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henrietta Johnson Medical Center 601 New Castle Ave Wilmington DE 19801-5821 Ph: (302) 655-6187 | Henrietta Johnson Medical Center 600 N Lombard St Wilmington DE 19801-4429 Ph: (302) 761-4610 |
| NPI Number | 1639417280 |
|---|---|
| Provider Enumeration Date | 01/16/2013 |
| Last Update Date | 01/16/2013 |
| Medicare PECOS PAC ID | 8426967928 |
|---|---|
| Medicare Enrollment ID | O20130717000061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639417280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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