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General NPI Number Information
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NPI Number | 1932944964
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Entity Type | Organization
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Legal Business Name | SANA WOUND CARE LLC
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Dates
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Enumeration Date | 07/01/2024
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 27 W TOWNSHIP ST
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2821
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Country | US
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Telephone | 479-900-5692
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Fax | 479-888-7700
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Provider Business Mailing Address
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Address Line | 22 W COLT SQUARE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2813
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Country | US
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Telephone | 479-480-6677
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Fax | 479-888-7700
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Authorized Official
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Title or Position | OWNER
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Name | KATINKA VAN DER MERWE
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Credential | DC
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Telephone | 479-480-6677
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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 | 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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