Provider Demographics
NPI:1396074019
Name:NATIONAL WELLNESS CARE PLAN ASSOCIATION
Entity type:Organization
Organization Name:NATIONAL WELLNESS CARE PLAN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:866-638-7500
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-0141
Mailing Address - Country:US
Mailing Address - Phone:866-638-7500
Mailing Address - Fax:909-307-8510
Practice Address - Street 1:711 S CARSON ST
Practice Address - Street 2:STE 4
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5292
Practice Address - Country:US
Practice Address - Phone:866-638-7500
Practice Address - Fax:909-307-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty