Wound Company Provider Group, P.A.
LBN: Wound Company Provider Group, P.A.
Wound Company Provider Group, P.A. is an health care organization with primary practice located at 2240 Drew Ave S , Minneapolis MN 55416-3646. The organization recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Continence Care, Nursing Service Providers / Enterostomal Therapy, Nursing Service Providers / Wound Care. Nursing Service Providers / Wound Care is the primary health care specialty.
Wound Company Provider Group, P.A. can be contacted via phone (858) 774-6305, or through Jolly, Brantley Tilman via phone (703) 447-6897.
Contact Information
Primary practice address
2240 Drew Ave S
Minneapolis MN 55416-3646
Phone: (858) 774-6305
Fax:
Website:
Authorized official contact:
Name: Jolly, Brantley Tilman Doctor of Medicine (MD)
Phone: (703) 447-6897
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Continence Care | 163WC2100X | ||
Nursing Service Providers / Enterostomal Therapy | 163WE0900X | ||
Nursing Service Providers / Wound Care | 163WW0000X |
Profile Details
NPI number | 1225749542 |
---|---|
LBN Legal business name | Wound Company Provider Group, P.A. |
DBA Doing business as | |
Authorized official | Jolly, Brantley Tilman Doctor of Medicine (MD) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Dec 7th, 2022 |
Last updated | Dec 7th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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