| Brookside | |
|
27 Marrows Rd Newark DE 19713-3701 | |
| (302) 455-0900 | |
| (302) 738-0176 |
| Full Name | Brookside |
|---|---|
| Speciality | Clinic/Center |
| Location | 27 Marrows Rd, Newark, Delaware |
| Authorized Official Name and Position | Lolita A. Lopez (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3026568292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookside Po Box 151 New Castle DE 19720-0151 Ph: (302) 655-5822 | Brookside 27 Marrows Rd Newark DE 19713-3701 Ph: (302) 455-0900 |
| NPI Number | 1801898556 |
|---|---|
| Provider Enumeration Date | 08/12/2005 |
| Last Update Date | 04/20/2022 |
| Medicare PECOS PAC ID | 6800706599 |
|---|---|
| Medicare Enrollment ID | O20040428001062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801898556 | NPI | - | NPPES |
| 0000356566 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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