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General NPI Number Information
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NPI Number | 1487469896
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Entity Type | Organization
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Legal Business Name | WELLCARE TRANSIT INC
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 310 MID CONTINENT PLZ STE 615
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-1760
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Country | US
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Telephone | 870-394-4681
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Fax | 870-394-4938
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Provider Business Mailing Address
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Address Line | 310 MID CONTINENT PLZ STE 615
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-1760
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Country | US
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Telephone | 870-394-4681
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Fax | 870-394-4938
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | MRS. CALANDRA C KIMBROUGH
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Credential |
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Telephone | 870-394-4681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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