Provider Demographics
NPI:1841055092
Name:LOGOS WOUND CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:LOGOS WOUND CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSO
Authorized Official - Prefix:
Authorized Official - First Name:BRODERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HEKKING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-481-0935
Mailing Address - Street 1:1200 WOODRUFF RD STE 187
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5730
Mailing Address - Country:US
Mailing Address - Phone:801-712-2075
Mailing Address - Fax:
Practice Address - Street 1:1200 WOODRUFF RD STE 187 BUILDING A3
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5730
Practice Address - Country:US
Practice Address - Phone:801-712-2075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty