Provider Demographics
NPI:1013487032
Name:WE CARE NEPHROLOGY LLC
Entity Type:Organization
Organization Name:WE CARE NEPHROLOGY LLC
Other - Org Name:WE CARE NEPHROLOGY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-346-6649
Mailing Address - Street 1:100 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1812
Mailing Address - Country:US
Mailing Address - Phone:302-503-3922
Mailing Address - Fax:302-503-7986
Practice Address - Street 1:100 KINGS HWY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1812
Practice Address - Country:US
Practice Address - Phone:302-422-0910
Practice Address - Fax:302-422-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEPENDINGOtherPENDING APPROVAL
DEPENDINGMedicaid