Provider Demographics
NPI:1992997365
Name:WELLCARE HOME HEALTH AGENCY LLC,
Entity type:Organization
Organization Name:WELLCARE HOME HEALTH AGENCY LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDILLAHI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-644-8118
Mailing Address - Street 1:3314 MORSE RD STE 216
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6100
Mailing Address - Country:US
Mailing Address - Phone:614-644-8118
Mailing Address - Fax:
Practice Address - Street 1:3314 MORSE RD STE 216
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6100
Practice Address - Country:US
Practice Address - Phone:614-644-8118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health