National Provider Identifier Database

STATE OF DELAWARE
Public Health, State or Local


Contact Information

STATE OF DELAWARE
417 FEDERAL ST
DOVER, DE19901-3635
Phone: 302-744-4849
Fax: 302-739-6627
Website:
Specialty Taxonomy Code
* Public Health, State or Local 261QP0905X

* Indicates primary specialty

NPI Profile & details for STATE OF DELAWARE

NPI Number 1275608630
Legal business name
LBN
STATE OF DELAWARE
Authorized official HERMAN ELLIS - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 11/21/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • DE Medicaid: 0000121049

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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