Organization
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
Active
Parent organization
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
Other names
Henrietta Johnson Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
Authorized official
MS. ROSA RIVERA (CHIEF EXECUTIVE OFFICER)
(302) 427-9696
Entity
Organization
Contact information
Practice address
600 N LOMBARD ST, WILMINGTON, DE 19801-4429
(302) 761-4610
(302) 655-6606
Mailing address
601 NEW CASTLE AVE, WILMINGTON, DE 19801-5821
(302) 655-6187
(302) 655-6606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/16/2013
Last updated
01/16/2013
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