1720131485 NPI number — THE NEMOURS FOUNDATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720131485 NPI number — THE NEMOURS FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE NEMOURS FOUNDATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720131485
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/31/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 404112
Provider Second Line Business Mailing Address:
C/O MANAGED CARE
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-4112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-390-3610
Provider Business Mailing Address Fax Number:
904-697-5630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 ENGLISH CREEK AVE
Provider Second Line Business Practice Location Address:
SUITE 1001
Provider Business Practice Location Address City Name:
EGG HARBOR TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08234-5549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-641-3700
Provider Business Practice Location Address Fax Number:
302-651-4549
Provider Enumeration Date:
01/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCKENDREE
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
VP, FINANCE
Authorized Official Telephone Number:
904-697-5628

Provider Taxonomy Codes

  • Taxonomy code: 261QD1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QG0250X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR1100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 072420 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5030129 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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