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General NPI Number Information
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NPI Number | 1376124461
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Entity Type | Organization
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Legal Business Name | WOUND CARE SPECIALISTS, LLC
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 22742 MIDLAND DR
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City | SHAWNEE
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State | KS
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Zip | 66226-3553
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Country | US
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Telephone | 913-620-2377
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Fax |
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Provider Business Mailing Address
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Address Line | 22742 MIDLAND DR
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City | SHAWNEE
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State | KS
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Zip | 66226-3553
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Country | US
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Telephone | 913-620-2377
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MATTHEW THOMAS GIANFORTE
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Credential | DC
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Telephone | 913-620-2377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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