Healthcare Provider Details

I. General information

NPI: 1801284732
Provider Name (Legal Business Name): WOUND CARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2014
Last Update Date: 12/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8671 TOMMY DR
SAN DIEGO CA
92119-2011
US

IV. Provider business mailing address

8671 TOMMY DRIVE
SAN DIEGO CA
92119
US

V. Phone/Fax

Practice location:
  • Phone: 619-718-2721
  • Fax: 619-713-6420
Mailing address:
  • Phone: 619-718-2721
  • Fax: 619-713-6420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number182029
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERRIGENE L ALLEN
Title or Position: OWNER
Credential: LVN, WCC
Phone: 619-718-2721