Provider Demographics
NPI:1376363291
Name:AMENITY WOUND CARE SOLUTIONS LLC
Entity type:Organization
Organization Name:AMENITY WOUND CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-800-9958
Mailing Address - Street 1:2900 CHAMBLEE TUCKER RD BLDG 14
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4100
Mailing Address - Country:US
Mailing Address - Phone:678-365-6358
Mailing Address - Fax:855-552-3776
Practice Address - Street 1:2900 CHAMBLEE TUCKER RD BLDG 14
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4100
Practice Address - Country:US
Practice Address - Phone:678-365-6358
Practice Address - Fax:855-552-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty