Provider Demographics
NPI:1336516350
Name:WELLCARE HEALTH MANAGEMENT, INC.
Entity Type:Organization
Organization Name:WELLCARE HEALTH MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HANG
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-881-0821
Mailing Address - Street 1:445 BROADHOLLOW RD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3669
Mailing Address - Country:US
Mailing Address - Phone:631-881-0821
Mailing Address - Fax:866-863-5865
Practice Address - Street 1:445 BROADHOLLOW RD
Practice Address - Street 2:SUITE 25
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3669
Practice Address - Country:US
Practice Address - Phone:631-881-0821
Practice Address - Fax:866-863-5865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care