Healthcare Provider Details

I. General information

NPI: 1699160960
Provider Name (Legal Business Name): WELLCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 JEFFERSON ST NE BUILDING A, STE 102
ALBUQUERQUE NM
87113-2457
US

IV. Provider business mailing address

6688 N CENTRAL EXPY SUITE 1300
DALLAS TX
75206-3950
US

V. Phone/Fax

Practice location:
  • Phone: 505-563-4005
  • Fax: 505-563-4022
Mailing address:
  • Phone: 214-239-6500
  • Fax: 214-239-6581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE DIANE JOLLEY
Title or Position: EVP OF HOME HEALTH OPERATIONS
Credential:
Phone: 214-239-6500