Provider Demographics
NPI:1427558840
Name:WGA HEALTHCARE
Entity Type:Organization
Organization Name:WGA HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIHUNGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-314-5186
Mailing Address - Street 1:4023 KENNETT PIKE STE 568
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-2018
Mailing Address - Country:US
Mailing Address - Phone:302-314-5186
Mailing Address - Fax:
Practice Address - Street 1:44 BERRY ST APT 205
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3542
Practice Address - Country:US
Practice Address - Phone:302-314-5186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
NJ38MC00678700261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center