Healthcare Provider Details

I. General information

NPI: 1861983199
Provider Name (Legal Business Name): AMERICAS WOUND CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7911 MALL RD
FLORENCE KY
41042-1409
US

IV. Provider business mailing address

7911 MALL RD
FLORENCE KY
41042-1409
US

V. Phone/Fax

Practice location:
  • Phone: 859-757-8262
  • Fax: 859-282-0976
Mailing address:
  • Phone: 859-757-8262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47852
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3008577
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00353
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT J HERBST
Title or Position: OWNER
Credential: DPM
Phone: 859-757-8262