Provider Demographics
NPI:1033122197
Name:WPS GROUP, LLC
Entity Type:Organization
Organization Name:WPS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:COUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-650-2802
Mailing Address - Street 1:15851 SW 41ST ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1541
Mailing Address - Country:US
Mailing Address - Phone:954-349-2990
Mailing Address - Fax:954-349-2949
Practice Address - Street 1:15851 SW 41ST ST
Practice Address - Street 2:SUITE 700
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-1541
Practice Address - Country:US
Practice Address - Phone:954-349-2990
Practice Address - Fax:954-349-2949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies