Provider Demographics
NPI:1518525815
Name:WICIS INC
Entity Type:Organization
Organization Name:WICIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF SALES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:CARLOTA
Authorized Official - Last Name:FENES
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:510-289-2929
Mailing Address - Street 1:111 W PROCTOR ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4133
Mailing Address - Country:US
Mailing Address - Phone:510-289-2929
Mailing Address - Fax:
Practice Address - Street 1:111 W PROCTOR ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4133
Practice Address - Country:US
Practice Address - Phone:510-289-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB9819859OtherDRIVER LICENSE