Provider Demographics
NPI:1831495373
Name:WOUND CARE CONSULTANTS LLC
Entity Type:Organization
Organization Name:WOUND CARE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-367-9444
Mailing Address - Street 1:23250 CHAGRIN BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5419
Mailing Address - Country:US
Mailing Address - Phone:440-821-3642
Mailing Address - Fax:330-574-1050
Practice Address - Street 1:23250 CHAGRIN BLVD STE 450
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5419
Practice Address - Country:US
Practice Address - Phone:440-821-3642
Practice Address - Fax:330-574-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003471213ES0103X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBE4228483Medicare PIN