# STATE OF DELAWARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATE OF DELAWARE
- **Other names:** State of DE - DOC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114512068
- **Legal business name:** STATE OF DELAWARE
- **Authorized official:** DR. AWELE N. MADUKA-EZEH (MEDICAL DIRECTOR)
- **Authorized official phone:** (302) 739-5601

## Contact information

- **Practice address:** 660 BAYLOR BLVD, NEW CASTLE, DE 19720-1140
- **Practice address phone:** (302) 577-3004
- **Mailing address:** 245 MCKEE RD, DOVER, DE 19904-2232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/03/2021
- **Last updated:** 03/03/2021