Healthcare Provider Details

I. General information

NPI: 1851603799
Provider Name (Legal Business Name): OHIO WOUND AND HYPERBARIC CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MIAMI VALLEY DR STE 220 MIAMI VALLEY HOSPITAL
CENTERVILLE OH
45459-4774
US

IV. Provider business mailing address

2400 MIAMI VALLEY DR STE 220 MIAMI VALLEY HOSPITAL
CENTERVILLE OH
45459-4774
US

V. Phone/Fax

Practice location:
  • Phone: 937-305-3254
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DARIN J PANGALANGAN
Title or Position: MEMBER, LLC
Credential: MD
Phone: 937-438-4977