Provider Demographics
NPI:1497847297
Name:TRI-COUNTY WOUND CARE CENTER, INC
Entity Type:Organization
Organization Name:TRI-COUNTY WOUND CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARMUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN WCC
Authorized Official - Phone:215-518-9998
Mailing Address - Street 1:55 BUCK ROAD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006
Mailing Address - Country:US
Mailing Address - Phone:215-518-9998
Mailing Address - Fax:215-396-6650
Practice Address - Street 1:55 BUCK ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006
Practice Address - Country:US
Practice Address - Phone:215-518-9998
Practice Address - Fax:215-396-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN335748L163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty