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General NPI Number Information
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NPI Number | 1144190422
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Entity Type | Organization
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Legal Business Name | WOUND100 MEDICAL ALABAMA LLC
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 4000 EAGLE POINT CORPORATE DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-1900
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Country | US
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Telephone | 402-651-6040
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Fax |
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Provider Business Mailing Address
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Address Line | 19681 CHICAGO ST APT A
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City | ELKHORN
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State | NE
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Zip | 68022-6525
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Country | US
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Telephone | 402-651-6040
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. LEAH FORD
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Credential | DPM
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Telephone | 561-400-5303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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