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General NPI Number Information
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NPI Number | 1811998990
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Entity Type | Organization
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Legal Business Name | WELL CARE HOME HEALTH OF THE TRIANGLE
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 5400 GLENWOOD AVE STE 310
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City | RALEIGH
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State | NC
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Zip | 27612-3148
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Country | US
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Telephone | 919-846-1018
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Fax | 919-846-5954
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Provider Business Mailing Address
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Address Line | 131 RACINE DR STE 201
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City | WILMINGTON
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State | NC
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Zip | 28403-8752
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Country | US
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Telephone | 910-362-9405
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Fax | 910-202-1376
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | LISA MOORE
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Credential |
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Telephone | 910-362-9405
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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 | HC0074
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License Number State | NC
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