Provider Demographics
NPI:1568837946
Name:WELL CARE HOME HEALTH OF THE TRIAD, INC
Entity type:Organization
Organization Name:WELL CARE HOME HEALTH OF THE TRIAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, COMPLIANCE AND QUALITY
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-362-9405
Mailing Address - Street 1:131 RACINE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8752
Mailing Address - Country:US
Mailing Address - Phone:910-362-9405
Mailing Address - Fax:910-202-1376
Practice Address - Street 1:146 DORNACH WAY STE 210
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-7305
Practice Address - Country:US
Practice Address - Phone:336-753-6200
Practice Address - Fax:336-751-9287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health