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Organization

STATE OF DELAWARE

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

Provider details

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

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261QP2400X
Prison Health Clinic/Center
Primary

Other

Enumeration date
03/03/2021
Last updated
03/03/2021
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