MEDICARE: VITAL WOUND AND FOOT CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RN0300X	Nephrology Physician
2	363L00000X	Nurse Practitioner
3	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1326837477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL WOUND AND FOOT CARE LLC

Provider Business Mailing Address
First Line	:	607 W DUE WEST AVE STE 113
Second Line	:
City	:	MADISON
State	:	TN
Zip	:	37115-4428
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 W DUE WEST AVE STE 113
Second Line	:
City	:	MADISON
State	:	TN
Zip	:	37115-4428
Country	:	US
Telephone Number	:	901-791-1711
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TEKA ROLFE
Credential	:
Telephone Number	:	919-223-8208

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	08/15/2025

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Directions to “VITAL WOUND AND FOOT CARE LLC ” Practice Location

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