Healthcare Provider Details

I. General information

NPI: 1205205176
Provider Name (Legal Business Name): COMPREHENSIVE WOUND CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 F ST NW STE 804
WASHINGTON DC
20037-2760
US

IV. Provider business mailing address

2112 F ST NW STE 804
WASHINGTON DC
20037-2760
US

V. Phone/Fax

Practice location:
  • Phone: 202-861-2971
  • Fax:
Mailing address:
  • Phone: 202-861-2971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN JOHNSON
Title or Position: OWNER
Credential:
Phone: 202-861-2971