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Contact Information

SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
600 N LOMBARD ST
WILMINGTON, DE19801-4429
 Phone: 302-761-4610
 Fax: 302-655-6606
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC

NPI Number 1639417280
LBN Legal business name SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
Authorized official ROSA RIVERA - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 01/16/2013
Last updated 01/16/2013 - About 13 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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