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General NPI Number Information
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NPI Number | 1093012502
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Entity Type | Organization
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Legal Business Name | WELLCARE HOME HEALTH INC.
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 1515 E TROPICANA AVE STE 520
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City | LAS VEGAS
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State | NV
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Zip | 89119-6522
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Country | US
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Telephone | 702-366-1495
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 E TROPICANA AVE STE 520
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City | LAS VEGAS
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State | NV
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Zip | 89119-6522
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Country | US
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Telephone | 702-366-1495
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Fax |
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Authorized Official
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Title or Position | OWNER/SEC
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Name | MR. LARRY GAID FRONDA
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Credential |
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Telephone | 702-476-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | NV20101498795
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License Number State | NV
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