Provider Demographics
NPI:1861942542
Name:WOMEN'S MOBILE HEALTH SCREENING, LLC
Entity type:Organization
Organization Name:WOMEN'S MOBILE HEALTH SCREENING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-778-1102
Mailing Address - Street 1:111 W 11TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1225
Mailing Address - Country:US
Mailing Address - Phone:302-778-1102
Mailing Address - Fax:302-778-1104
Practice Address - Street 1:165 COMMERCE WAY STE 2
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8224
Practice Address - Country:US
Practice Address - Phone:302-672-6435
Practice Address - Fax:302-672-7834
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DELAWARE BREAST CANCER COALITION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service