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Organization
WELLCARE PHARMACY & HOME INFUSION LLC
Active
Organization
WELLCARE PHARMACY & HOME INFUSION LLC
Active
Other names
Wellcare Pharmacy & Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
GARY RAYMOND KAYLOR (PRESIDENT)
(318) 212-9990
Entity
Organization
Contact information
Practice address
4160 AIRLINE DR, BOSSIER CITY, LA 71111-2050
(318) 212-9990
(318) 212-9993
Mailing address
4160 AIRLINE DR, BOSSIER CITY, LA 71111-2050
(318) 212-9990
(318) 212-9993
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1235679
LA
3336C0003X
Community/Retail Pharmacy
Primary
6168-IR
NULL
Other
Enumeration date
03/19/2007
Last updated
06/05/2013
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