Provider Demographics
NPI:1962019521
Name:WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.
Entity Type:Organization
Organization Name:WELLCARE HEALTH PLANS OF MASSACHUSETTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, TAX
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DINKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-288-5441
Mailing Address - Street 1:8735 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1143
Mailing Address - Country:US
Mailing Address - Phone:800-288-5441
Mailing Address - Fax:
Practice Address - Street 1:8735 HENDERSON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1143
Practice Address - Country:US
Practice Address - Phone:800-288-5441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization