Provider Demographics
NPI:1891485181
Name:PROFESSIONAL WOUND CARE SERVICES OF ALABAMA INC.
Entity Type:Organization
Organization Name:PROFESSIONAL WOUND CARE SERVICES OF ALABAMA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-338-6655
Mailing Address - Street 1:2804 DR JOHN HAYNES DR
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-1438
Mailing Address - Country:US
Mailing Address - Phone:205-338-6655
Mailing Address - Fax:205-338-6658
Practice Address - Street 1:3804 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-3051
Practice Address - Country:US
Practice Address - Phone:205-338-6655
Practice Address - Fax:205-338-6658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty