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STATE OF DELAWARE

Medical Equipment Supplier Yellow Pages

Smyrna, Delaware

Provider NPI: 1851340350

Organization Information:
Organization Name:  STATE OF DELAWARE


Practice Location:
100 SUNNYSIDE ROAD  SMYRNA, DE 19977 US
Tel: 302-223-1373  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336L0003XSuppliers
Pharmacy
Long Term Care Pharmacy
DEA30000691

Other Provider Identifiers:

IssuerNumberStateType
00001210149DE05
0000121049DE05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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