Healthcare Provider Details

I. General information

NPI: 1972746121
Provider Name (Legal Business Name): WELL HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1654 MASSACHUSETTS AVE APT 37
CAMBRIDGE MA
02138-2725
US

IV. Provider business mailing address

1654 MASSACHUSETTS AVE APT 37
CAMBRIDGE MA
02138-2725
US

V. Phone/Fax

Practice location:
  • Phone: 646-400-0997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES OH
Title or Position: PRESIDENT
Credential:
Phone: 646-400-0997