SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC


Address: 601 New Castle Ave, Wilmington, DE 19801
Phone: 3026556187

SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC (NPI# 1770699621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770699621
Entity Type Organization
Organization Name SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
Other Organization Name HENRIETTA JOHNSON MEDICAL CENTER
Practice Address 601 New Castle Ave
Wilmington
DE 19801
Practice Telephone 3026556187
Practice Fax Number 3026556606
Mailing Telephone 3026556187
Mailing Fax Number 3026556606
Enumeration Date 2006-08-22
Last Update Date 2013-01-16
Authorized Official Name MS. ROSA V RIVERA (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 3026556187
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 122300000X Dentist Dental Providers
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 207VG0400X Obstetrics & Gynecology
Specialization: Gynecology
Allopathic & Osteopathic Physicians
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
DE 0000332866 05
TRAIL BLAZER 458117 01

Other Provider/Organization Names

Other Name Type Code
Henrietta Johnson Medical Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1639417280 Southbridge Medical Advisory Council Inc Dentist 600 N Lombard St, Wilmington, DE 19801-4429 2013-01-16

Office Location

Street Address 601 NEW CASTLE AVE
City WILMINGTON
State DE
Zip Code 19801

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710901012 Charles G Case Family Medicine 601 New Castle Ave, Wilmington, DE 19801-5821 2006-07-27
1609389477 Valeria Marie Muhammad Nurse Practitioner 601 New Castle Ave, Wilmington, DE 19801-5821 2017-11-14
1013447952 Vavah Fiase Physician Assistant 601 New Castle Ave, Wilmington, DE 19801-5821 2017-06-13
1881138337 Tina Solomon Nurse Practitioner 601 New Castle Ave, Wilmington, DE 19801-5821 2016-12-16
1063816312 Lekesha Mcphail Registered Nurse 601 New Castle Ave, Wilmington, DE 19801-5821 2014-10-15
1073944773 Stacy Bradshaw Nurse Practitioner 601 New Castle Ave, Wilmington, DE 19801-5821 2013-12-05
1407117724 Stanley Ogden Dunn Jr. Pediatrics 601 New Castle Ave, Wilmington, DE 19801-5821 2012-06-04
1235386939 Jendayi Gantt Advanced Practice Midwife 601 New Castle Ave, Wilmington, DE 19801-5821 2008-08-25
1750406955 Flavius A. Akerele Obstetrics & Gynecology 601 New Castle Ave, Wilmington, DE 19801-5821 2007-03-20
1083747521 Zita Aquino Dentist 601 New Castle Ave, Dental Clinic, Wilmington, DE 19801-5821 2007-03-13
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

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

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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

Competitor

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City WILMINGTON
Zip Code 19801

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Dataset Information

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.

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