Healthcare Provider Details

I. General information

NPI: 1346977949
Provider Name (Legal Business Name): WELLCARE DME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119-40 METROPOLITAN AVENUE UNIT CU2 SUITE 102
KEW GARDENS NY
11415
US

IV. Provider business mailing address

11940 METROPOLITAN AVE UNIT CU2 SUITE 102
KEW GARDENS NY
11415-2600
US

V. Phone/Fax

Practice location:
  • Phone: 646-321-3089
  • Fax: 516-407-5285
Mailing address:
  • Phone: 917-294-5667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: NADARA RAHMAN
Title or Position: PRESIDENT
Credential:
Phone: 917-294-5667