Provider Demographics
NPI:1083456636
Name:ELITE WOUND CARE CENTER LLC
Entity type:Organization
Organization Name:ELITE WOUND CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOMQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-465-7363
Mailing Address - Street 1:2810 CENTRAL AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4651
Mailing Address - Country:US
Mailing Address - Phone:406-465-7363
Mailing Address - Fax:
Practice Address - Street 1:2810 CENTRAL AVE STE C
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4651
Practice Address - Country:US
Practice Address - Phone:406-465-7363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty