Healthcare Provider Details
I. General information
NPI: 1649034794
Provider Name (Legal Business Name): SKP WOUND CARE OF ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/09/2024
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
145 COUNTY ROAD 314
TOWN CREEK AL
35672-3137
US
IV. Provider business mailing address
9032 MEMORIAL PKWY SW STE A1394
HUNTSVILLE AL
35802-3013
US
V. Phone/Fax
- Phone: 423-838-4444
- Fax:
- Phone: 888-341-5571
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
E
KRESS
Title or Position: CEO
Credential:
Phone: 615-393-4477