MEDICARE: W CARE LLC

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	3336H0001X	Home Infusion Therapy Pharmacy
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336S0011X	Specialty Pharmacy
5	3336C0003X	Community/Retail Pharmacy	PHC02855	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2136783	OTHER		PK

General Provider Information

NPI Number	:	1861741837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W CARE LLC

Provider Business Mailing Address
First Line	:	4845 S RAINBOW BLVD
Second Line	:	STE 403
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4916
Country	:	US
Telephone Number	:	702-538-9388
Fax Number	:	702-776-8982

Provider Business Practice Location Address
First Line	:	4845 S RAINBOW BLVD STE 403
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4750
Country	:	US
Telephone Number	:	702-538-9388
Fax Number	:	702-776-8982

Authorized Official
Title or Position	:	OWNER/PHCY MANAGER
Name	:	JOHN OKOYE
Credential	:
Telephone Number	:	702-538-9388

Provider Enumeration Date	:	09/05/2012
Last Update Date	:	04/12/2017

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Directions to “W CARE LLC ” Practice Location

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