MEDICARE: WELLCARE HOME HEALTH INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	NV20101498795	NV

General Provider Information

NPI Number	:	1093012502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLCARE HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	1515 E TROPICANA AVE STE 520
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6522
Country	:	US
Telephone Number	:	702-366-1495
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 E TROPICANA AVE STE 520
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6522
Country	:	US
Telephone Number	:	702-366-1495
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SEC
Name	:	MR. LARRY GAID FRONDA
Credential	:
Telephone Number	:	702-476-3394

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	09/24/2013

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