Provider Demographics
NPI:1356142806
Name:ADVANCED WOUND CARE SOLUTIONS PC
Entity type:Organization
Organization Name:ADVANCED WOUND CARE SOLUTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-270-0590
Mailing Address - Street 1:1059 ANTLERS LN
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650-9420
Mailing Address - Country:US
Mailing Address - Phone:603-728-8395
Mailing Address - Fax:
Practice Address - Street 1:1059 ANTLERS LN
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-9420
Practice Address - Country:US
Practice Address - Phone:603-728-8395
Practice Address - Fax:866-902-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty