MEDICARE: DERMACORE WOUND CARE

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1760340756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DERMACORE WOUND CARE

Provider Business Mailing Address
First Line	:	871 CORONADO CENTER DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3977
Country	:	US
Telephone Number	:	702-660-0809
Fax Number	:	702-659-8039

Provider Business Practice Location Address
First Line	:	871 CORONADO CENTER DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3977
Country	:	US
Telephone Number	:	702-660-0809
Fax Number	:	702-659-8039

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MICHELLE LABAO
Credential	:
Telephone Number	:	702-660-0809

Provider Enumeration Date	:	01/10/2026
Last Update Date	:	01/10/2026

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Directions to “DERMACORE WOUND CARE ” Practice Location

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