Provider Demographics
NPI:1285440461
Name:WOUND CARE HEALTH GROUP
Entity type:Organization
Organization Name:WOUND CARE HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KWASI
Authorized Official - Middle Name:
Authorized Official - Last Name:BADU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-341-4466
Mailing Address - Street 1:1940 W CHANDLER BLVD STE 2-403
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6176
Mailing Address - Country:US
Mailing Address - Phone:602-341-4466
Mailing Address - Fax:
Practice Address - Street 1:4667 S LAKESHORE DR STE 7
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7293
Practice Address - Country:US
Practice Address - Phone:602-341-4466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility