Provider Demographics
NPI:1861774945
Name:WECARE MEDICAL SOMERSET, LLC
Entity type:Organization
Organization Name:WECARE MEDICAL SOMERSET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-206-0040
Mailing Address - Street 1:220 W GERMANTOWN PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1437
Mailing Address - Country:US
Mailing Address - Phone:610-630-6357
Mailing Address - Fax:
Practice Address - Street 1:1420 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-2326
Practice Address - Country:US
Practice Address - Phone:606-343-0202
Practice Address - Fax:606-343-0073
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WECARE MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-14
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100290010Medicaid
KY7100290010Medicaid