Provider Demographics
NPI:1881820512
Name:ANNETTE M. WELLINGTON-HALL, INC
Entity type:Organization
Organization Name:ANNETTE M. WELLINGTON-HALL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-437-9880
Mailing Address - Street 1:5830 SHERIDAN STREET
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-437-9880
Mailing Address - Fax:954-437-9881
Practice Address - Street 1:5830 SHERIDAN STREET
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-437-9880
Practice Address - Fax:954-437-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993762251J00000X, 374U00000X, 251E00000X
FL10D2012729291U00000X
347C00000X, 372600000X, 376J00000X
FL230571347C00000X
FL29993762376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No291U00000XLaboratoriesClinical Medical Laboratory
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL230571OtherACHA
FL299993762OtherACHA