NPI Code Details Logo

NPI 1457238362

NPI 1457238362 : ELITE WOUND CARE LLC : ATLANTA, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1457238362
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ELITE WOUND CARE LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/20/2025
-----------------------------------------------------
    Last Update Date     |    10/12/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3372 PEACHTREE RD NE STE 115 
-----------------------------------------------------
    City                 |    ATLANTA
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30326-1963
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    404-781-3363
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3372 PEACHTREE RD NE STE 115 
-----------------------------------------------------
    City                 |    ATLANTA
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30326-1963
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    AUTHORIZED OFFICIAL
-----------------------------------------------------
    Name                 |     LILLIAN  A. LANE 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    404-781-3363
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.