Provider Demographics
NPI:1699180240
Name:ADVANCED WOUND OSTOMY AND CONTINENCE CARE LLC
Entity Type:Organization
Organization Name:ADVANCED WOUND OSTOMY AND CONTINENCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-897-0063
Mailing Address - Street 1:PO BOX 773663
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34477-3663
Mailing Address - Country:US
Mailing Address - Phone:352-897-0063
Mailing Address - Fax:
Practice Address - Street 1:2220 SW 146TH AVENUE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-5258
Practice Address - Country:US
Practice Address - Phone:352-897-0063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty