Wellcare of New Jersey, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WELLCARE OF NEW JERSEY, INC.

Practice address

318 West Applegate Ave
Pen Argyl, PA 18072-1816

Phone

(610) 863-3055

Fax

(610) 863-3036

NPI assigned

Mar 24, 2008

Last updated

Mar 18, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Duane Impeciati

Title

Manager

Phone

(610) 863-3055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1417129057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 W APPLEGATE AVE",
            "address_2": "PO BOX 318",
            "city": "PEN ARGYL",
            "state": "PA",
            "postal_code": "180721425",
            "telephone_number": "610-863-3055",
            "fax_number": "610-863-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 WEST APPLEGATE AVE",
            "city": "PEN ARGYL",
            "state": "PA",
            "postal_code": "180721816",
            "telephone_number": "610-863-3055",
            "fax_number": "610-863-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE OF NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "IMPECIATI",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "610-863-3055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009640730001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Pen Argyl, PA
• Providers in Pen Argyl, PA by specialty
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.