Provider Demographics
NPI:1881993483
Name:WP GROUP INC
Entity type:Organization
Organization Name:WP GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALI
Authorized Official - Middle Name:G
Authorized Official - Last Name:PANARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-245-3961
Mailing Address - Street 1:5909 SE ABSHIER BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-4025
Mailing Address - Country:US
Mailing Address - Phone:352-245-3961
Mailing Address - Fax:
Practice Address - Street 1:5909 SE ABSHIER BLVD
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-4025
Practice Address - Country:US
Practice Address - Phone:352-245-3961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH253443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN