# RIDGAWAY PHILIPS OF DE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811064959
- **Authorized official:** MS. JACQUELINE S MOORE (PRESIDENT)
- **Authorized official phone:** (215) 643-1200

## Contact information

- **Practice address:** 908 CHURCHMANS ROAD EXT, SUITE B, NEW CASTLE, DE 19720-3109
- **Practice address phone:** (302) 323-1436
- **Practice address fax:** (302) 323-1481
- **Mailing address:** 908 CHURCHMANS ROAD EXT, SUITE B, NEW CASTLE, DE 19720-3109
- **Mailing address phone:** (302) 323-1436
- **Mailing address fax:** (302) 323-1481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 2003109630 | DE | Yes |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0001987000 | IBC | PA |
| 01 | — | 0001989000 | AMERIHEALTH HMO | PA |
| 01 | — | 0001990000 | IBC | PA |
| 05 | — | 1000024008 | — | DE |
| 01 | — | 1000033612 | DE PHYSICIANS CARE, INC | AZ |
| 01 | — | 1526 | GENTIVA | CT |
| 01 | — | 157A46 | BC BS OF DE | DE |
| 01 | — | 201484 | COVENTRY HEALTH CARE | KY |
| 01 | — | 3333942 | AETNA LIFE INS, CO | TX |
| 01 | — | 4492440 | AETNA | TX |
| 01 | — | 5701000157A460 | INDEPENDENT LICENSE BC BS | DE |