Provider Demographics
NPI:1669171997
Name:MOBILE WOUND SPECIALISTS NETWORK, LLC
Entity type:Organization
Organization Name:MOBILE WOUND SPECIALISTS NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:TUSHINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:548-217-5769
Mailing Address - Street 1:4577 N NOB HILL RD STE 212
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4715
Mailing Address - Country:US
Mailing Address - Phone:954-821-7576
Mailing Address - Fax:954-634-6444
Practice Address - Street 1:470 OLDE WORTHINGTON RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9127
Practice Address - Country:US
Practice Address - Phone:954-821-7576
Practice Address - Fax:954-634-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care