Organization Name: | WCI MANAGEMENT SERVICES LLC |
NPI Number: | 1407124076 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN J PEASE (CEO) |
Mailing Address: | 650 New York Street Memphis |
State: | TN US |
Postal Code: | 38104 |
Phone Number: | 9017285858 |
Fax Number: | 9015316312 |
NPI Enumeration Date: | 12/09/2011 |
NPI Last Update Date: | 12/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13712 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |