Provider Demographics
NPI:1497183677
Name:WOUND HEALING AND LIMB PRESERVATION CENTER OF PHILADELPHIA LLC
Entity Type:Organization
Organization Name:WOUND HEALING AND LIMB PRESERVATION CENTER OF PHILADELPHIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:DONOHUE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-909-7365
Mailing Address - Street 1:748 CAMP WOODS RD
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1029
Mailing Address - Country:US
Mailing Address - Phone:610-909-7365
Mailing Address - Fax:610-293-1969
Practice Address - Street 1:5800 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1737
Practice Address - Country:US
Practice Address - Phone:610-909-7365
Practice Address - Fax:610-293-1969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNELIUS DONOHUE DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001995L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty