# WELLCARE PHYSICIANS GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Women's Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265875959
- **Authorized official:** AMY L BAHNSEN (CREDENTIALING SUPERVISOR)
- **Authorized official phone:** (419) 824-7334

## Contact information

- **Practice address:** 6135 TRUST DR, SUITE 114, HOLLAND, OH 43528-9358
- **Practice address phone:** (419) 491-0041
- **Practice address fax:** (419) 491-0042
- **Mailing address:** 6135 TRUST DR, SUITE 114, HOLLAND, OH 43528-9358
- **Mailing address phone:** (419) 491-0041
- **Mailing address fax:** (419) 491-0042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | OH | Yes |

## Other

- **Enumeration date:** 04/11/2013
- **Last updated:** 04/11/2013