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General NPI Number Information
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NPI Number | 1265373997
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Entity Type | Organization
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Legal Business Name | RENEWAL WOUND CARE GEORGIA LLC
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 408 E DEKALB ST STE A
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City | CAMDEN
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State | SC
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Zip | 29020-4429
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Country | US
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Telephone | 770-213-8376
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Fax |
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Provider Business Mailing Address
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Address Line | 125 OAKSIDE CT STE 202
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City | CANTON
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State | GA
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Zip | 30114-2498
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Country | US
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Telephone | 770-213-8376
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Fax | 800-692-2098
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Authorized Official
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Title or Position | OWNER
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Name | NEHA AMIN
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Credential |
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Telephone | 908-770-6832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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