Provider Demographics
NPI:1164289294
Name:WELLCRAFT HEALTH PLLC
Entity Type:Organization
Organization Name:WELLCRAFT HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-917-8410
Mailing Address - Street 1:52 CROSS PT
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NC
Mailing Address - Zip Code:27850-9457
Mailing Address - Country:US
Mailing Address - Phone:252-204-4259
Mailing Address - Fax:252-541-2765
Practice Address - Street 1:40 ANNA LOUISE LN
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-8648
Practice Address - Country:US
Practice Address - Phone:252-917-8410
Practice Address - Fax:252-541-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty