Healthcare Provider Details

I. General information

NPI: 1760258156
Provider Name (Legal Business Name): WELVIE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N MAY ST STE 202
CHICAGO IL
60642-5836
US

IV. Provider business mailing address

1277 TREAT BLVD STE 800
WALNUT CREEK CA
94597-8864
US

V. Phone/Fax

Practice location:
  • Phone: 800-676-6777
  • Fax:
Mailing address:
  • Phone: 800-676-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. RASHMI NIJAGAL
Title or Position: GENERAL COUNSEL
Credential: JD
Phone: 925-677-4797