Healthcare Provider Details
I. General information
NPI: 1861774945
Provider Name (Legal Business Name): WECARE MEDICAL SOMERSET, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2011
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1420 N MAIN ST STE 1
MONTICELLO KY
42633-2326
US
IV. Provider business mailing address
220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US
V. Phone/Fax
- Phone: 606-343-0202
- Fax: 606-343-0073
- Phone: 610-630-6357
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
P
GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040