MEDICARE: PERRY HOME WOUND CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1740152511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERRY HOME WOUND CARE LLC

Provider Business Mailing Address
First Line	:	211 RUSTY PLOW LN
Second Line	:
City	:	PERRY
State	:	GA
Zip	:	31069-9870
Country	:	US
Telephone Number	:	478-310-4446
Fax Number	:	478-721-9473

Provider Business Practice Location Address
First Line	:	211 RUSTY PLOW LN
Second Line	:
City	:	PERRY
State	:	GA
Zip	:	31069-9870
Country	:	US
Telephone Number	:	478-442-9926
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JEPTHE NKWANMEN
Credential	:	RN
Telephone Number	:	478-442-9926

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	02/06/2026

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Directions to “PERRY HOME WOUND CARE LLC ” Practice Location

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