MEDICARE: WELLCARE, 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

General Provider Information

NPI Number	:	1699160960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLCARE, INC.

Provider Business Mailing Address
First Line	:	6688 N CENTRAL EXPY
Second Line	:	SUITE 1300
City	:	DALLAS
State	:	TX
Zip	:	75206-3950
Country	:	US
Telephone Number	:	214-239-6500
Fax Number	:	214-239-6581

Provider Business Practice Location Address
First Line	:	8801 JEFFERSON ST NE
Second Line	:	BUILDING A, STE 102
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-2457
Country	:	US
Telephone Number	:	505-563-4005
Fax Number	:	505-563-4022

Authorized Official
Title or Position	:	EVP OF HOME HEALTH OPERATIONS
Name	:	JULIE DIANE JOLLEY
Credential	:
Telephone Number	:	214-239-6500

Provider Enumeration Date	:	04/02/2015
Last Update Date	:	12/23/2024

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