Healthcare Provider Details

I. General information

NPI: 1346036340
Provider Name (Legal Business Name): MOBILE WOUND CARE OF ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 COLONY DR
FAIRHOPE AL
36532-7178
US

IV. Provider business mailing address

428 COLONY DR
FAIRHOPE AL
36532-7178
US

V. Phone/Fax

Practice location:
  • Phone: 251-510-2682
  • Fax:
Mailing address:
  • Phone: 251-510-2682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: WENDY BUTLER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 251-510-2682