Provider Demographics
NPI:1821711656
Name:WOUND CARE AT HOME, INC.
Entity Type:Organization
Organization Name:WOUND CARE AT HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:DEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-739-8400
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:MASCOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:34753-0005
Mailing Address - Country:US
Mailing Address - Phone:407-739-8400
Mailing Address - Fax:
Practice Address - Street 1:7170 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-2022
Practice Address - Country:US
Practice Address - Phone:407-739-8400
Practice Address - Fax:352-718-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty