NPIMap

Organization Active NPI

Christiana Care Health Services Inc

Doing business as Christiana Care Pharmacy - Wilmington

  • Community/Retail Pharmacy
  • Wilmington, DE
National Provider Identifier
1639219082
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
A30000880 Issued in DE
Legal business name
CHRISTIANA CARE HEALTH SERVICES INC
Doing business as
Christiana Care Pharmacy - Wilmington
Practice address
501 W 14TH St
Wilmington, DE 19801-1013
Phone
(302) 428-6843
Fax
(302) 428-2669
NPI assigned
Feb 7, 2007
Last updated
Oct 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTIANA CARE HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samuel Wetherill
Title
Vice President, Pharmacy Services
Phone
(302) 733-5855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X A30000880 DE Primary

Addresses

Primary practice location

501 W 14TH St
Wilmington, DE 19801-1013

Mailing address

501 W 14TH St
Wilmington, DE 19801-1013
Phone (302) 428-6843

Other identifiers 2

IdentifierTypeStateIssuer
0803141OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0000819907MedicaidDE

Other names 1

  • Christiana Care Pharmacy - Wilmington Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170908002944 DE Part B Supplier - Pharmacy 9739097569 Practice locations: Wilmington, DE
O20171215000940 DE DME Supplier - Pharmacy 9739097569 Practice locations: Wilmington, DE

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

National Provider Directory

National Provider Directory
Part of
WMC Family Practice

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Union Hospital of Cecil CountyElkton, MD, CCN 210032 Hospital 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control (100%)		 Jan 1, 2020
Jan 1, 2020
Christianacare Hospital, West GroveWest Grove, PA, CCN 390431 Hospital 5% Or Greater Indirect Ownership Interest (51%) Oct 9, 2023
Christianacare HomehealthSmyrna, DE, CCN 087301 Home health agency Operational/Managerial Control (100%) Jul 1, 2021
Christianacare-Accentcare Hospice & Palliative Care of DelawareNewark, DE, CCN 081508 Hospice 5% Or Greater Direct Ownership Interest (40%) Jun 1, 2021

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1639219082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "302-428-6843",
            "fax_number": "302-428-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 14TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "302-428-6843",
            "fax_number": "302-428-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIANA CARE HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIANA CARE HEALTH SERVICES INC",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "WETHERILL",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, PHARMACY SERVICES",
        "authorized_official_telephone_number": "302-733-5855"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DE",
            "license": "A30000880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0803141",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000819907",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christiana Care Pharmacy - Wilmington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.