Provider Demographics
NPI:1316097678
Name:WOUND CARE SERVICE INC
Entity type:Organization
Organization Name:WOUND CARE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOGARTIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:919-784-2580
Mailing Address - Street 1:4420 LAKE BOONE TRL
Mailing Address - Street 2:REX WOUND HEALING CENTER
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7505
Mailing Address - Country:US
Mailing Address - Phone:919-784-2580
Mailing Address - Fax:919-784-2581
Practice Address - Street 1:4420 LAKE BOONE TRL
Practice Address - Street 2:REX WOUND HEALING CENTER
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7505
Practice Address - Country:US
Practice Address - Phone:919-784-2580
Practice Address - Fax:919-784-2581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center