Provider Demographics
NPI:1568563005
Name:WELLCARE RESPIRATORY & HME, INC.
Entity Type:Organization
Organization Name:WELLCARE RESPIRATORY & HME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-592-4346
Mailing Address - Street 1:11233 ROJAS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-5409
Mailing Address - Country:US
Mailing Address - Phone:915-592-4346
Mailing Address - Fax:915-592-4369
Practice Address - Street 1:11233 ROJAS DR
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-5409
Practice Address - Country:US
Practice Address - Phone:915-592-4346
Practice Address - Fax:915-592-4369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMQ0306Medicaid
NMQ0306Medicaid