Provider Demographics
NPI:1518125418
Name:WECARE EXTENDED MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:WECARE EXTENDED MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:502-819-4318
Mailing Address - Street 1:8206 SALEM CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111
Mailing Address - Country:US
Mailing Address - Phone:502-819-4318
Mailing Address - Fax:
Practice Address - Street 1:8206 SALEM CHURCH RD
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-9262
Practice Address - Country:US
Practice Address - Phone:502-819-4318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46008163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty