Healthcare Provider Details

I. General information

NPI: 1518586825
Provider Name (Legal Business Name): EMSITE WOUND CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 PEACHTREE INDUSTRIAL BLVD STE 290
SUWANEE GA
30024-8494
US

IV. Provider business mailing address

1500 PEACHTREE INDUSTRIAL BLVD STE 290
SUWANEE GA
30024-8494
US

V. Phone/Fax

Practice location:
  • Phone: 678-722-8866
  • Fax: 678-233-2121
Mailing address:
  • Phone: 678-722-8866
  • Fax: 678-233-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YVENER LIBERAL
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 678-564-4658