Provider Demographics
NPI:1376613653
Name:WCE, LLC
Entity Type:Organization
Organization Name:WCE, LLC
Other - Org Name:COOP OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANGELISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-366-5100
Mailing Address - Street 1:660 WOODWARD
Mailing Address - Street 2:SUITE 1525
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226
Mailing Address - Country:US
Mailing Address - Phone:313-366-5100
Mailing Address - Fax:313-366-2246
Practice Address - Street 1:660 WOODWARD
Practice Address - Street 2:SUITE 1525
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226
Practice Address - Country:US
Practice Address - Phone:313-366-5100
Practice Address - Fax:313-366-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1376613653OtherNPI BILLING NUMBER
MI0469550006Medicare NSC
MI0469550005Medicare NSC
0469550003Medicare NSC
MI0469550007Medicare NSC
MIT33610Medicare UPIN
MI0469550011Medicare NSC
MIU81848Medicare UPIN
MI0469550010Medicare NSC
MI1376613653OtherNPI BILLING NUMBER
MI0469550009Medicare NSC
MIU69183Medicare UPIN
MIU21472Medicare UPIN
MIV00946Medicare UPIN
MIU38776Medicare UPIN
MI0469550004Medicare NSC
MIU59150Medicare UPIN
MIT81442Medicare UPIN
MI0469550008Medicare NSC
MI0469550003Medicare NSC
MI0469550014Medicare NSC
MI0469550002Medicare NSC