Healthcare Provider Details

I. General information

NPI: 1134032634
Provider Name (Legal Business Name): PRIMEHEAL WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 KENMORE RD
HAVERTOWN PA
19083-3908
US

IV. Provider business mailing address

405 KENMORE RD
HAVERTOWN PA
19083-3908
US

V. Phone/Fax

Practice location:
  • Phone: 215-760-9443
  • Fax:
Mailing address:
  • Phone: 215-760-9443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KARAPET DAVTYAN
Title or Position: OWNER
Credential: MD
Phone: 215-760-9443