# WELLCARE FAMILY MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WELLCARE FAMILY MEDICINE PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558444885
- **Authorized official:** DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
- **Authorized official phone:** (800) 654-0889

## Contact information

- **Practice address:** 9757 WESTPOINT DR, INDIANAPOLIS, IN 46256-3341
- **Practice address phone:** (317) 577-2779
- **Practice address fax:** (317) 577-2546
- **Mailing address:** 9757 WESTPOINT DR, INDIANAPOLIS, IN 46256-3341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | IN | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/22/2020