SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC (NPI# 1639417280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639417280 |
| Entity Type | Organization |
| Organization Name | SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC |
| Other Organization Name | HENRIETTA JOHNSON MEDICAL CENTER |
| Practice Address |
600 N Lombard St Wilmington DE 19801-4429 |
| Mailing Address |
601 New Castle Ave Wilmington DE 19801-5821 |
| Practice Telephone | 3027614610 |
| Practice Fax Number | 3026556606 |
| Mailing Telephone | 3026556187 |
| Mailing Fax Number | 3026556606 |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |
| Authorized Official Name | MS. ROSA RIVERA (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3024279696 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Henrietta Johnson Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770699621 | Southbridge Medical Advisory Council Inc | Dentist | 601 New Castle Ave, Wilmington, DE 19801 | 2006-08-22 |
| Street Address |
600 N LOMBARD ST |
| City | WILMINGTON |
| State | DE |
| Zip Code | 19801-4429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750425625 | State of Delaware | Local Education Agency (LEA) | 600 N Lombard St, Wilmington, DE 19801-4429 | 2007-02-16 |
| 1841702719 | Alexandra Woodard | Occupational Therapist | 600 N Lombard St, Wilmington, DE 19801-4429 | 2017-10-31 |
| 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 | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1457512691 | New Hanover Community Health Center Incorporated | Clinic/Center | 240 Calhoun Dr, Wilmington, NC 28412-6202 | 2008-06-20 |
| 1669479929 | Westside Family Healthcare, Inc. | Clinic/Center | 1802 W 4th St, Wilmington, DE 19805-3420 | 2005-07-01 |
| 1861958829 | The Childrens Clinic 'serving Children and Their Families' | Clinic/Center | 445 E Anaheim St, Wilmington, CA 90744-4600 | 2019-02-14 |
| 1346588985 | Butler County Community Health Consortium Inc | Clinic/Center | 953 S South St, Wilmington, OH 45177-2921 | 2013-01-16 |
| 1417266537 | Healthsource of Ohio, Inc. | Clinic/Center | 140 W Main St, Wilmington, OH 45177-2239 | 2010-10-07 |
| 1821232869 | Westside Family Healthcare, Inc | Clinic/Center | 1802 W 4th St, Wilmington, DE 19805-3420 | 2009-04-21 |
| 1457512766 | New Hanover Community Health Center Incorporated | Clinic/Center | 1805 S 13th St, Wilmington, NC 28401-6469 | 2008-06-19 |
| 1912954090 | New Hanover Community Health Center Incorporated | Clinic/Center | 925 N 4th St, Wilmington, NC 28401-3450 | 2006-05-27 |
| 1952303695 | Westside Family Healthcare, Inc. | Clinic/Center | 908 E 16th St Ste B, Wilmington, DE 19802-5145 | 2005-08-12 |
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|---|---|---|---|---|
| 1780165175 | La Red Health Center, Inc. | Clinic/Center | 26089 Long Neck Road, Millsboro, DE 19966 | 2018-08-24 |
| 1922535616 | La Red Health Center, Inc | Clinic/Center | 30637 Cedar Neck Road, Ocean View, DE 19970 | 2017-05-12 |
| 1750762126 | La Red Health Center, Inc. | Clinic/Center | 21 W Clarke Ave Ste 1001, Milford, DE 19963-1840 | 2015-06-11 |
| 1700832185 | La Red Health Center Inc | Clinic/Center | 21444 Carmean Way, Georgetown, DE 19947-4572 | 2006-05-26 |
| 1790004786 | La Red Health Center, Inc. | Clinic/Center | 1057 S Bradford St, Dover, DE 19904-4141 | 2010-05-31 |
| 1497071161 | La Red Health Center, Inc. | Clinic/Center | 300 High St, Seaford, DE 19973-3940 | 2010-04-20 |
| 1811171978 | La Red Health Center Inc | Clinic/Center | 21444 Carmean Way, Georgetown, DE 19947-4572 | 2007-12-26 |
| 1225163199 | Delmarva Rural Ministries, Inc. | Clinic/Center | 26 Wyoming Ave, Dover, DE 19904-6922 | 2007-02-22 |
| 1801898556 | Westside Family Healthcare, Inc | Clinic/Center | 27 Marrows Rd, Newark, DE 19713-3701 | 2005-08-12 |
| City | WILMINGTON |
| Zip Code | 19801 |
Please comment or provide details below to improve the information on SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC.
| 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.