OLIVE BRANCH MEDICAL LLC (NPI# 1144846197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144846197 |
| Entity Type | Organization |
| Organization Name | OLIVE BRANCH MEDICAL LLC |
| Practice Address |
530 Harlan Blvd Unit 404 Wilmington DE 19801-5170 |
| Practice Telephone | 4437189470 |
| Practice Fax Number | 6622146092 |
| Mailing Telephone | 4437189470 |
| Mailing Fax Number | 6622146092 |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-07-21 |
| Authorized Official Name | DR. AMY ZHANG (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4437189470 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Olive Branch Medical Systems | Doing Business As Name - Organization |
| Street Address |
530 HARLAN BLVD UNIT 404 |
| City | WILMINGTON |
| State | DE |
| Zip Code | 19801-5170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386126068 | Meghan Cullen | Specialist/Technologist | 401 Garasches Lane, Wilmington, DE 19801 | 2018-08-30 |
| 1497257851 | Jevs Human Services | Psychologist | 300 Delaware Avenue, Suite 210, Wilmington, DE 19801 | 2018-03-01 |
| 1134627144 | Limen House, Inc | Substance Abuse Rehabilitation Facility | 1104 N. Adams Street / Triad, Wilmington, DE 19801 | 2018-01-24 |
| 1538698980 | Triad Ministry Inc | Community/Behavioral Health | 1104 N. Adams Street, Wilmington, DE 19801 | 2017-06-08 |
| 1649706086 | Fhr -act Program | Health Maintenance Organization | 103a Rogers Rd., Wilmington, DE 19801 | 2017-05-04 |
| 1275080707 | Suzanne Isenberg | Social Worker | 103 Rogers Roaad, Wilmington, DE 19801 | 2016-09-01 |
| 1467815191 | Jenna Leigh Laughlin | Internal Medicine | 501 W 14th St., Wilmington, DE 19801 | 2016-03-31 |
| 1962830430 | Antoinette L. Rodriguez | Counselor | 500 W 10th St., Connections Community Support Programs Inc., Wilmington, DE 19801 | 2013-10-21 |
| 1104173509 | Connections Community Support Programs, Inc. | Clinic/Center | 500 W. 10th Street, Wilmington, DE 19801 | 2012-08-06 |
| 1366719916 | Richard Mclaughlin | Counselor | 109 W. 7th St, Crossroads of Delaware, Wilmington, DE 19801 | 2011-11-28 |
| Find all providers in zip 19801 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893734 | Blue Telepsych Urgent Care | Clinic/Center | 8406 Fiddlestick Way, Wilmington, NC 28412-3394 | 2020-08-28 |
| 1669940722 | Wilmington Chiropractic and Wellness Center LLC | Clinic/Center | 576 Prairie Ave, Wilmington, OH 45177-1770 | 2018-11-07 |
| 1932298668 | Coastal Carolina Heart, LLC | Clinic/Center | 1604 Physicians Dr, Suite 104, Wilmington, NC 28401-7362 | 2006-10-12 |
| 1386751048 | Robert N. Dumin, M.d. | Clinic/Center | 1504 Turkey Run Rd, Wilmington, DE 19803-3918 | 2006-08-25 |
| 1801813456 | Partners In Endocrinology and Diabetes Pllc | Clinic/Center | 1501 Medical Center Dr, Wilmington, NC 28401-7506 | 2006-07-17 |
| 1699154880 | Wilmington Family Eye Care LLC | Clinic/Center | 801 E Newport Pike, Wilmington, DE 19804-1920 | 2015-05-21 |
| 1528454683 | Greenville As, LLC | Clinic/Center | 3801 Kennett Pike, E126, Wilmington, DE 19807-2321 | 2015-04-15 |
| 1215278726 | Family Eye Care, LLC | Clinic/Center | 410 Foulk Rd, Suite 102, Wilmington, DE 19803-3820 | 2013-03-07 |
| 1447406327 | Azalea Coast Plastic Surgery, Pa | Clinic/Center | 1604 Physicians Dr, Suite 103, Wilmington, NC 28401-7362 | 2008-08-12 |
| 1760649545 | Seacoast Skin Surgery Pllc | Clinic/Center | 710 Military Cutoff Rd, Suite 200, Wilmington, NC 28405-2375 | 2008-05-20 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 19801 |
Please comment or provide details below to improve the information on OLIVE BRANCH MEDICAL LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.