Healthcare Provider Details

I. General information

NPI: 1871018457
Provider Name (Legal Business Name): WCS PROFESSIONAL SERVICES OF VIRGINIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11803 JEFFERSON AVE STE 120
NEWPORT NEWS VA
23606-2565
US

IV. Provider business mailing address

3445 NORTH CAUSEWAY SUITE 600
METAIRIE LA
70002
US

V. Phone/Fax

Practice location:
  • Phone: 757-594-1060
  • Fax: 888-572-9218
Mailing address:
  • Phone: 504-835-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PATRICK SEILER
Title or Position: CFO
Credential:
Phone: 504-835-4919