Provider Demographics
NPI:1952826554
Name:WCS PROFESSIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:WCS PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:COGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-835-4919
Mailing Address - Street 1:3445 N CAUSEWAY BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3762
Mailing Address - Country:US
Mailing Address - Phone:504-609-3282
Mailing Address - Fax:
Practice Address - Street 1:124 HAYES ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-8005
Practice Address - Country:US
Practice Address - Phone:504-835-4919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty