Basic Information
| Provider Information | |||||||||
| NPI: | 1639715501 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WECARE TLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 INTERNATIONAL PKWY STE 220 | ||||||||
| Address2: | |||||||||
| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327465049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4075621212 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1854 WAYNE RD | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172028836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172007229 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2019 | ||||||||
| LastUpdateDate: | 11/26/2019 | ||||||||
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| AuthorizedOfficialLastName: | MCKINNEY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMIN OPERATIONS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4075621212 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.