MEDICARE: MAXIMUM WOUND CARE SOLUTIONS LLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1275373151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIMUM WOUND CARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	3305 SPRING MOUNTAIN RD STE 45
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8622
Country	:	US
Telephone Number	:	725-293-6677
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 SPRING MOUNTAIN RD STE 45
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8622
Country	:	US
Telephone Number	:	725-293-6677
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	IREDILA BYNUM
Credential	:	NP
Telephone Number	:	725-293-6677

Provider Enumeration Date	:	05/29/2024
Last Update Date	:	05/29/2024

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