Provider Demographics
NPI:1508468059
Name:WOUND CARE SUPPLIES LLC
Entity Type:Organization
Organization Name:WOUND CARE SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGOMILSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-375-1566
Mailing Address - Street 1:PO BOX 403311
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-1311
Mailing Address - Country:US
Mailing Address - Phone:305-375-8876
Mailing Address - Fax:877-391-2770
Practice Address - Street 1:4014 CHASE AVE STE 215
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3446
Practice Address - Country:US
Practice Address - Phone:305-763-8876
Practice Address - Fax:877-391-2770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies