1568563005 NPI number — WELLCARE RESPIRATORY & HME, INC.

Table of content: (NPI 1568563005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568563005 NPI number — WELLCARE RESPIRATORY & HME, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELLCARE RESPIRATORY & HME, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568563005
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11233 ROJAS DR
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79935-5409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-592-4346
Provider Business Mailing Address Fax Number:
915-592-4369

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11233 ROJAS DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79935-5409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-592-4346
Provider Business Practice Location Address Fax Number:
915-592-4369
Provider Enumeration Date:
09/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAYDAR
Authorized Official First Name:
YASSER
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
915-592-4346

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Q0306 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com