FAIRFAX MEDICAL P.A. NPI 1235443854

Clinic/Center (Urgent Care) in Wilmington, DE

About FAIRFAX MEDICAL P.A.

Fairfax Medical P.a. is a provider in Wilmington, DE. The NPI number assigned to this provider is 1235443854. The practitioner's primary taxonomy code is Clinic/Center (261QU0200X). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Doctors Express Wilmington.

NPI

1235443854

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameFAIRFAX MEDICAL P.A.
Provider Location Address2105 CONCORD PIKE SUITE A WILMINGTON, DE 19803 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 283 MONTCHANIN, DE 19710 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameDOCTORS EXPRESS WILMINGTON Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date08-06-2010 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date08-06-2010 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code261QU0200X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationUrgent Care
License No.2010604214
License StateDE

Business Address

FAIRFAX MEDICAL P.A.
2105 CONCORD PIKE
SUITE A
WILMINGTON, DE
ZIP 19803
Phone: (302) 654-5000

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Mailing Address

FAIRFAX MEDICAL P.A.
PO BOX 283
MONTCHANIN, DE
ZIP 19710
Phone: (302) 655-1704

Authorized Official

Authorized Official NameMR. EDWARD H MURPHY Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleAUTHORIZED REPRESENTATIVE
Authorized Official Phone(302) 655-1704
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