Provider Demographics
NPI:1154481448
Name:FOCUSED WOUND CARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:FOCUSED WOUND CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRIGINIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MEZEI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, ANP-CS
Authorized Official - Phone:636-357-5455
Mailing Address - Street 1:263 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:MO
Mailing Address - Zip Code:63332-1018
Mailing Address - Country:US
Mailing Address - Phone:636-357-5455
Mailing Address - Fax:636-482-4864
Practice Address - Street 1:263 CLAY ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:MO
Practice Address - Zip Code:63332-1018
Practice Address - Country:US
Practice Address - Phone:636-357-5455
Practice Address - Fax:636-482-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO135280363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty