Provider Demographics
NPI:1508054271
Name:ADVANCED WOUND SYSTEMS LLC
Entity Type:Organization
Organization Name:ADVANCED WOUND SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-876-5480
Mailing Address - Street 1:1120 PINELLAS BAYWAY S
Mailing Address - Street 2:STE 200
Mailing Address - City:TIERRA VERDE
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1543
Mailing Address - Country:US
Mailing Address - Phone:727-867-5480
Mailing Address - Fax:727-867-5470
Practice Address - Street 1:1120 PINELLAS BAYWAY S
Practice Address - Street 2:STE 200
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33715-1543
Practice Address - Country:US
Practice Address - Phone:727-867-5480
Practice Address - Fax:727-867-5470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5442490001Medicare NSC