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PED083300-02 Nemours Children's Hospital, Delaware (Terminated)
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Main Details
Name
Nemours Children's Hospital, Delaware
Subdivision Name
Bryn Mawr / Anesthesiology
Type
Children's Hospital
Rural
No
340B ID
PED083300-02
Medicare Provider Number
083300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/2/2015
Last Recertification Date
9/8/2022
Termination Date
Termination Reason
1/1/2023
Site closure
Contacts
Authorizing Official
Alfred I dupont Hospital or Children
Ryan Forman, Vice President of Finance
(302) 256-6060
Primary Contact
Nemours
Robert Mullen, Sr Director of Patient Operations
(302) 651-5711
Addresses
Street Address
825 Old Lancaster Road
Suite 250
Bryn Mawr, PA 19010
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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