Provider Demographics
NPI:1699015057
Name:WELL CARE CENTRAL INC
Entity Type:Organization
Organization Name:WELL CARE CENTRAL INC
Other - Org Name:SMILE URGICENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CLIVE
Authorized Official - Last Name:LYNTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-400-3000
Mailing Address - Street 1:PO BOX 7079
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95763-7079
Mailing Address - Country:US
Mailing Address - Phone:916-817-8400
Mailing Address - Fax:866-801-6429
Practice Address - Street 1:1360 E NATOMA ST STE 140
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-5714
Practice Address - Country:US
Practice Address - Phone:916-817-8400
Practice Address - Fax:916-817-8488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70542261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care