Provider Demographics
NPI:1851924625
Name:COMMUNITY WOUND RESOURCE, LLC
Entity type:Organization
Organization Name:COMMUNITY WOUND RESOURCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF HUMAN RESOURCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-208-4437
Mailing Address - Street 1:515 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-6546
Mailing Address - Country:US
Mailing Address - Phone:903-475-3474
Mailing Address - Fax:903-942-2930
Practice Address - Street 1:515 N 3RD ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-6546
Practice Address - Country:US
Practice Address - Phone:903-475-3474
Practice Address - Fax:903-942-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty