Provider Demographics
NPI:1659472975
Name:WELLCARE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:WELLCARE ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WELZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-584-9355
Mailing Address - Street 1:PO BOX 13774
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-3774
Mailing Address - Country:US
Mailing Address - Phone:915-584-9355
Mailing Address - Fax:915-845-5772
Practice Address - Street 1:671 S MESA HILLS DR
Practice Address - Street 2:SUITE 1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5563
Practice Address - Country:US
Practice Address - Phone:915-584-9355
Practice Address - Fax:915-845-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45-H041Medicare ID - Type UnspecifiedMEDICARE PROVIDER #