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General NPI Number Information
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NPI Number | 1336516350
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Entity Type | Organization
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Legal Business Name | WELLCARE HEALTH MANAGEMENT, INC.
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Dates
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Enumeration Date | 08/25/2015
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 445 BROADHOLLOW RD SUITE 25
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City | MELVILLE
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State | NY
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Zip | 11747-3669
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Country | US
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Telephone | 631-881-0821
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Fax | 866-863-5865
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Provider Business Mailing Address
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Address Line | 445 BROADHOLLOW RD SUITE 25
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City | MELVILLE
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State | NY
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Zip | 11747-3669
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Country | US
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Telephone | 631-881-0821
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Fax | 866-863-5865
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Authorized Official
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Title or Position | CEO
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Name | MR. HANG GUO
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Credential |
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Telephone | 631-881-0821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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