Organization
WELLCARE OF NEW JERSEY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUANE IMPECIATI (MANAGER)
(610) 863-3055
Entity
Organization
Contact information
Practice address
318 WEST APPLEGATE AVE, PEN ARGYL, PA 18072-1816
(610) 863-3055
(610) 863-3036
Mailing address
318 W APPLEGATE AVE, PO BOX 318, PEN ARGYL, PA 18072-1425
(610) 863-3055
(610) 863-3036
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009640730001
—
PA
Enumeration date
03/24/2008
Last updated
03/18/2016
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