Yes
DE | | 1467505073,1386830859,1649323262 |
PA | | 1467505073,1386830859,1649323262 |
NJ | | 1467505073,1386830859,1649323262 |
MD | | 1467505073,1386830859,1649323262 |
PED083300-01 | Child | PED | ALFRED I DUPONT HOSP FOR CHILDREN | Bryn Mawr / Outpatient Surgery | 825 Old Lancaster Road | Bryn Mawr | PA | Terminated |
PED083300-02 | Child | PED | Nemours Children's Hospital, Delaware | Bryn Mawr / Anesthesiology | 825 Old Lancaster Road | Bryn Mawr | PA | Terminated |
PED083300-03 | Child | PED | Nemours Children's Hospital, Delaware | Bryn Mawr / Radiology | 825 Old Lancaster Road | Bryn Mawr | PA | Terminated |
PED083300-04 | Child | PED | Nemours Children's Hospital, Delaware | Bryn Mawr / Outpatient Therapy Services | 825 Old Lancaster Road | Bryn Mawr | PA | Terminated |
PED083300-05 | Child | PED | Nemours Children's Hospital, Delaware | Bryn Mawr / Ambulatory Care Center | 825 Old Lancaster Road | Bryn Mawr | PA | Terminated |
PED083300-06 | Child | PED | Nemours Children's Hospital, Delaware | DPF MRI - MRI | 1280 Almonnesson Road | Deptford | NJ | Active |
PED083300-07 | Child | PED | Nemours Children's Hospital, Delaware | DPF Radiology - Radiology | 1280 Almonesson Road | Deptford | NJ | Active |
PED083300-08 | Child | PED | Nemours Children's Hospital, Delaware | DPF Anesthesiology - Anesthesiology | 1280 Almonesson Road | Deptford | NJ | Active |
PED083300-09 | Child | PED | Nemours Children's Hospital, Delaware | DPF Ambulatory Care Center - Ambulatory Care Center | 1280 Almonesson Road | Deptford | NJ | Active |
PED083300-10 | Child | PED | Nemours Children's Hospital, Delaware | DPF Ultrasound - Ultrasound | 1280 Almonesson Road | Deptford | NJ | Active |
PED083300-11 | Child | PED | Nemours Children's Hospital, Delaware | DPF Audiologyy - Audiology | 1280 Almonesson Road | Deptford | NJ | Active |
PED083300-12 | Child | PED | Nemours Children's Hospital, Delaware | DPF Day Medicine - Day Medicine | 1280 Almonesson Road | Deptford | NJ | Active |
PED083300-13 | Child | PED | Nemours Children's Hospital, Delaware | DPF Outpatient Therapy Services - Outpatient Therapy Services | 1280 Almonesson Road | deptford | NJ | Active |
Details | Last Recertification Date | Update | Recertification | 8/30/2023 10:18:52 AM | 8/20/2024 2:11:54 PM | 8/20/2024 2:11 PM |
Details | Last Recertification Date | Update | Recertification | 9/8/2022 12:40:21 PM | 8/30/2023 10:18:52 AM | 8/30/2023 10:18 AM |
Contacts | Primary Contact | Update | Recertification | Mullen, Robert
Senior Director, Patient Operations
Alfred I duPont Hospital for Children
3026515711 | Mullen, Robert
Vice President, Patient Operations
Alfred I duPont Hospital for Children
3026515711 | 2/6/2023 10:10 AM |
Details | Last Recertification Date | Update | Recertification | 8/31/2021 9:34:05 AM | 9/8/2022 12:40:21 PM | 9/8/2022 12:40 PM |
Details | Entity Name | Update | Change Request | NEMOURS/ALFRED I DUPONT HOSPITAL FOR CHILDREN | Nemours Children's Hospital, Delaware | 1/12/2022 1:46 PM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1467505073 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | DE | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1386830859 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | DE | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1649323262 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | DE | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1467505073 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | PA | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1386830859 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | PA | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1649323262 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | PA | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1467505073 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | NJ | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1386830859 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | NJ | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1649323262 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | NJ | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1467505073 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | MD | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1386830859 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | MD | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1649323262 | 12/6/2021 11:27 AM |
Medicaid Billing | NPI: State | Insert | Change Request | | MD | 12/6/2021 11:27 AM |
Details | Last Recertification Date | Update | Recertification | 8/28/2020 11:24:19 AM | 8/31/2021 9:34:05 AM | 8/31/2021 9:34 AM |
Contacts | Authorizing Official | Update | Change Request | BRITTON, WILLIAM
Operating Vice President for Finance - Delaware
Nemours
3026514000 | Forman, Ryan
Vice President of Finance
Alfred I dupont Hospital or Children
3022566060 | 12/8/2020 9:43 AM |
Contacts | Primary Contact | Update | Change Request | Mullen, Robert
Seniort Director of Pharmacy and Nutrition
Nemours
3026515711 | Mullen, Robert
Senior Director, Patient Operations
Alfred I duPont Hospital for Children
3026515711 | 12/7/2020 11:10 AM |
Details | Last Recertification Date | Update | Recertification | 8/27/2019 10:18:29 AM | 8/28/2020 11:24:19 AM | 8/28/2020 11:24 AM |
Details | Last Recertification Date | Update | Recertification | 8/23/2018 1:13:50 PM | 8/27/2019 10:18:29 AM | 8/27/2019 10:18 AM |
Contacts | Primary Contact | Update | Recertification | Mullen, Robert
Director of Pharmacy
Nemours
3026515711 | Mullen, Robert
Seniort Director of Pharmacy and Nutrition
Nemours
3026515711 | 8/27/2019 10:13 AM |
Contacts | Authorizing Official | Update | Profile Change Request | BRITTON, WILLIAM
CHIEF FINANCIAL OFFICER
Nemours
3026514000 | BRITTON, WILLIAM
Operating Vice President for Finance - Delaware
Nemours
3026514000 | 8/13/2019 11:57 AM |
Contacts | Signed By | Update | Profile Change Request | BRITTON, WILLIAM
CHIEF FINANCIAL OFFICER
Nemours
3026514000 | BRITTON, WILLIAM
Operating Vice President for Finance - Delaware
Nemours
3026514000 | 8/13/2019 11:57 AM |
Details | Last Recertification Date | Update | Recertification | | 8/23/2018 1:13:50 PM | 8/23/2018 1:13 PM |
Details | State | Update | | Approved | Active | 4/1/2018 12:00 AM |
Contacts | Signed By | Insert | New Registration | | BRITTON, WILLIAM
CHIEF FINANCIAL OFFICER
Nemours
3026514000 | 1/25/2018 12:59 PM |
Details | 340B ID | Update | New Registration | | PED083300-12 | 1/25/2018 12:59 PM |
Details | Entity Subname | Update | New Registration | DPF Day Medicine | DPF Day Medicine - Day Medicine | 1/25/2018 12:59 PM |
Dates | Participating Approval Date | Update | New Registration | | 1/25/2018 12:59:48 PM | 1/25/2018 12:59 PM |
Details | State | Update | New Registration | Pending | Approved | 1/25/2018 12:59 PM |
Dates | Signed By Date | Update | New Registration | | 1/15/2018 11:42:16 AM | 1/25/2018 12:59 PM |
Dates | Start Date | Update | New Registration | | 4/1/2018 12:00:00 AM | 1/25/2018 12:59 PM |
Addresses | Main Address | Insert | New Registration | |
1280 Almonesson Road
Deptford, NJ 08096 | 1/10/2018 9:19 AM |
Contacts | Primary Contact | Insert | New Registration | | Mullen, Robert
Director of Pharmacy
Nemours
3026515711 | 1/10/2018 9:19 AM |
Contacts | Authorizing Official | Insert | New Registration | | BRITTON, WILLIAM
CHIEF FINANCIAL OFFICER
Nemours
3026514000 | 1/10/2018 9:19 AM |
Details | Last Recertification Date | Insert | New Registration | | | 1/10/2018 9:19 AM |
Details | Grant Number | Insert | New Registration | | | 1/10/2018 9:19 AM |
Details | 340B ID | Insert | New Registration | | | 1/10/2018 9:19 AM |
Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 1/10/2018 9:19 AM |
Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 1/10/2018 9:19 AM |
Details | Medicare Provider Number | Insert | New Registration | | 083300 | 1/10/2018 9:19 AM |
Details | Entity Name | Insert | New Registration | | NEMOURS/ALFRED I DUPONT HOSPITAL FOR CHILDREN | 1/10/2018 9:19 AM |
Details | Program Code | Insert | New Registration | | PED | 1/10/2018 9:19 AM |
Details | Entity Subname | Insert | New Registration | | DPF Day Medicine | 1/10/2018 9:19 AM |
Dates | Participating Approval Date | Insert | New Registration | | | 1/10/2018 9:19 AM |
Details | State | Insert | New Registration | | Pending | 1/10/2018 9:19 AM |
Dates | Registration Date | Insert | New Registration | | 1/10/2018 9:19:37 AM | 1/10/2018 9:19 AM |
Dates | Signed By Date | Insert | New Registration | | | 1/10/2018 9:19 AM |
Dates | Start Date | Insert | New Registration | | | 1/10/2018 9:19 AM |
Terminations | Termination Comments | Insert | New Registration | | | 1/10/2018 9:19 AM |
Terminations | Termination Date | Insert | New Registration | | | 1/10/2018 9:19 AM |
Terminations | Termination Effective Date | Insert | New Registration | | | 1/10/2018 9:19 AM |
Terminations | Termination Reason | Insert | New Registration | | | 1/10/2018 9:19 AM |