Provider Demographics
NPI:1255116497
Name:WMGR INC
Entity type:Organization
Organization Name:WMGR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARELL
Authorized Official - Middle Name:DESHONDE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-612-7023
Mailing Address - Street 1:190 W SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2142
Mailing Address - Country:US
Mailing Address - Phone:213-712-3434
Mailing Address - Fax:
Practice Address - Street 1:190 W SCOTT ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2142
Practice Address - Country:US
Practice Address - Phone:213-712-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle