Provider Demographics
NPI:1134914518
Name:MOBILE WOUND CARE SERVICES - SOUTHEAST PC
Entity type:Organization
Organization Name:MOBILE WOUND CARE SERVICES - SOUTHEAST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-429-1901
Mailing Address - Street 1:4020 PROGRESSIVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NC
Mailing Address - Zip Code:27569-8621
Mailing Address - Country:US
Mailing Address - Phone:919-429-1901
Mailing Address - Fax:
Practice Address - Street 1:2099 N MOUNT JULIET RD STE 7
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3386
Practice Address - Country:US
Practice Address - Phone:919-429-1901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty