Provider Demographics
NPI:1942276761
Name:ADVANCED WOUND CARE CORPORATION
Entity Type:Organization
Organization Name:ADVANCED WOUND CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUYVESANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-238-7969
Mailing Address - Street 1:649 CRANDALL DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-1212
Mailing Address - Country:US
Mailing Address - Phone:814-238-7969
Mailing Address - Fax:
Practice Address - Street 1:649 CRANDALL DR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-1212
Practice Address - Country:US
Practice Address - Phone:814-238-7969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies