Provider Demographics
NPI:1407124076
Name:WCI MANAGEMENT SERVICES LLC
Entity type:Organization
Organization Name:WCI MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEASE
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:901-728-5858
Mailing Address - Street 1:650 NEW YORK STREET
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104
Mailing Address - Country:US
Mailing Address - Phone:901-728-5858
Mailing Address - Fax:901-531-6312
Practice Address - Street 1:650 NEW YORK STREET
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104
Practice Address - Country:US
Practice Address - Phone:901-728-5858
Practice Address - Fax:901-531-6312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13712208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty