Provider Demographics
NPI:1538138466
Name:THERAPEUTIC INNOVATIONS
Entity Type:Organization
Organization Name:THERAPEUTIC INNOVATIONS
Other - Org Name:TI WOUNDCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REIMBURSEMENT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:TURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-776-1890
Mailing Address - Street 1:PO BOX 20063
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0007
Mailing Address - Country:US
Mailing Address - Phone:540-776-1890
Mailing Address - Fax:540-776-8061
Practice Address - Street 1:6550 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-5160
Practice Address - Country:US
Practice Address - Phone:540-776-1890
Practice Address - Fax:540-776-8061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA13073332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4294543Medicaid
SCDM0349Medicaid
CO23582731Medicaid
NC7703035Medicaid
VA242215OtherANTHEM
TN4581718Medicaid
MS0440320Medicaid
PA1711070Medicaid
VA9106219Medicaid
OH0115888Medicaid
KY90172669Medicaid
NC7703035Medicaid
VA9106219Medicaid