Provider Demographics
NPI: | 1033614151 |
---|---|
Name: | WELL CARE HOME CARE, INC |
Entity Type: | Organization |
Organization Name: | WELL CARE HOME CARE, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ACCOUNTS RECEIVABLE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WENDIESUE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HOUGH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 910-338-5416 |
Mailing Address - Street 1: | 6752 PARKER FARM DR STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | WILMINGTON |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28405-3175 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 910-343-9996 |
Mailing Address - Fax: | 910-343-0352 |
Practice Address - Street 1: | 1801 STANLEY ROAD |
Practice Address - Street 2: | SUITE 325 |
Practice Address - City: | GREENSBORO |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27407-2644 |
Practice Address - Country: | US |
Practice Address - Phone: | 910-343-9996 |
Practice Address - Fax: | 910-343-0352 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-03-29 |
Last Update Date: | 2018-03-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care | |
No | 251E00000X | Agencies | Home Health | |
No | 251J00000X | Agencies | Nursing Care |