Provider Demographics
NPI:1356608178
Name:WSN INC
Entity type:Organization
Organization Name:WSN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOFUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-355-5404
Mailing Address - Street 1:10300 FOXLAKE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2607
Mailing Address - Country:US
Mailing Address - Phone:240-355-5404
Mailing Address - Fax:301-345-1339
Practice Address - Street 1:7217 HANOVER PARKWAY,SUITE A
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2607
Practice Address - Country:US
Practice Address - Phone:301-345-1124
Practice Address - Fax:301-345-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP056693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy