Organization
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.
Active
Parent organization
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.
Other names
Henrietta Johnson Medical Center Claymont
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.
Authorized official
MS. NACHET SCOTT (CEO)
(026) 593-0773
Entity
Organization
Contact information
Practice address
2722 PHILADELPHIA PIKE, CLAYMONT, DE 19703-2568
(302) 655-6187
(302) 798-2473
Mailing address
2722 PHILADELPHIA PIKE, CLAYMONT, DE 19703-2568
(026) 556-1873
(027) 982-4733
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440009
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER
DE
Enumeration date
03/03/2015
Last updated
05/21/2019
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