Organization
RIDGAWAY PHILIPS OF DE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE S MOORE (PRESIDENT)
(215) 643-1200
Entity
Organization
Contact information
Practice address
908 CHURCHMANS ROAD EXT, SUITE B, NEW CASTLE, DE 19720-3109
(302) 323-1436
(302) 323-1481
Mailing address
908 CHURCHMANS ROAD EXT, SUITE B, NEW CASTLE, DE 19720-3109
(302) 323-1436
(302) 323-1481
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2003109630
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001987000
IBC
PA
01
—
0001989000
KEYSTONE HEALTH PLAN
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
Enumeration date
11/30/2006
Last updated
08/22/2020
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