Lifespan Medical Services Llc | |
1125 Forrest Ave Dover DE 19904-3483 | |
(302) 346-0100 | |
(302) 346-0103 |
Full Name | Lifespan Medical Services Llc |
---|---|
Speciality | Internal Medicine |
Location | 1125 Forrest Ave, Dover, Delaware |
Authorized Official Name and Position | Harsha Tankala (OWNER/PRESIDENT) |
Authorized Official Contact | 3026780950 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lifespan Medical Services Llc 1125 Forrest Ave Dover DE 19904-3483 Ph: (302) 346-0100 | Lifespan Medical Services Llc 1125 Forrest Ave Dover DE 19904-3483 Ph: (302) 346-0100 |
NPI Number | 1427131382 |
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Provider Enumeration Date | 10/23/2006 |
Last Update Date | 06/21/2018 |
Medicare PECOS PAC ID | 0143323493 |
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Medicare Enrollment ID | O20070307000376 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427131382 | NPI | - | NPPES |
1000041898 | Medicaid | DE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | C1-0005962 (Delaware) | Primary |
Provider Name | Harsha Tankala |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1164441242 PECOS PAC ID: 7416900675 Enrollment ID: I20050228000686 |
Provider Name | Claudia Pierce |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770847402 PECOS PAC ID: 8022265297 Enrollment ID: I20140424001335 |
Provider Name | Candace E Finch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891334231 PECOS PAC ID: 4183045818 Enrollment ID: I20200604000444 |
Provider Name | Kaitlin Marie Fielder |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962001180 PECOS PAC ID: 1658787171 Enrollment ID: I20210309000571 |
Provider Name | Erin P Beaudry |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083859383 PECOS PAC ID: 0143369371 Enrollment ID: I20230515000134 |
Provider Name | Kimberly Corine Cano |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164280012 PECOS PAC ID: 4688116650 Enrollment ID: I20240605002063 |
Middletown Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 Federal St, Dover, DE 19901 Phone: 302-744-4849 Fax: 302-739-6627 | |
Northeast Family Planning Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 Federal St, Dover, DE 19901 Phone: 302-744-4548 Fax: 302-739-1613 | |
Kent Epsdt Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 Federal St, Dover, DE 19901 Phone: 302-744-4548 Fax: 302-739-1613 | |
Natwarlal V Ramani Md Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 742 S Governors Ave, Suite 3, Dover, DE 19904 Phone: 302-678-5008 Fax: 302-678-5505 | |
Lee Dennis, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 960 Forest St, Dover, DE 19904 Phone: 302-735-1888 | |
Dph Seaford Family Planning Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 Federal St, Dover, DE 19901 Phone: 302-744-4548 Fax: 302-739-1613 | |
Cdw South Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 Federal St, Dover, DE 19901 Phone: 302-744-4548 Fax: 302-739-1613 |