Healthcare Provider Details

I. General information

NPI: 1306317060
Provider Name (Legal Business Name): ELEANOR QUINITCHETE HYPERBARIC, WOUND CARE AND DIAGNOSTIC CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 SION FARM COMM CTR #8
CHRISTIANSTED VI
00820-4433
US

IV. Provider business mailing address

4100 SION FARM COMM CTR #8
CHRISTIANSTED VI
00820-4433
US

V. Phone/Fax

Practice location:
  • Phone: 340-626-3714
  • Fax: 877-349-0205
Mailing address:
  • Phone: 340-626-3714
  • Fax: 877-349-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. IAN KEITH COOK
Title or Position: PRESIDENT
Credential: DPM
Phone: 340-626-3714