MEDICARE: WOUNCARE PROVIDERS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1073728325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUNCARE PROVIDERS INC.

Provider Business Mailing Address
First Line	:	4500 CAMPUS DR
Second Line	:	# 560
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1814
Country	:	US
Telephone Number	:	949-757-0880
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 CAMPUS DR
Second Line	:	# 560
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1814
Country	:	US
Telephone Number	:	949-757-0880
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM S. JORRITSMA
Credential	:
Telephone Number	:	714-585-6123

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	08/22/2020

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