Provider Demographics
NPI:1962292409
Name:MOBILE WOUND CARE SOLUTIONS INC
Entity type:Organization
Organization Name:MOBILE WOUND CARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-571-0902
Mailing Address - Street 1:319 VANN DR STE E #60
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-6032
Mailing Address - Country:US
Mailing Address - Phone:731-571-0902
Mailing Address - Fax:
Practice Address - Street 1:1616 WESTGATE CIR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8019
Practice Address - Country:US
Practice Address - Phone:731-571-0902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty