| Complete Wound Care Llc | |
|
67 Masonic Ave Ste 2400 Wallingford CT 06492-3099 | |
| (203) 408-2462 | |
| Not Available |
| Full Name | Complete Wound Care Llc |
|---|---|
| Speciality | General Practice |
| Location | 67 Masonic Ave Ste 2400, Wallingford, Connecticut |
| Authorized Official Name and Position | Adrian Wyllie (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2034082462 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Wound Care Llc 20 Autumn Ct Cheshire CT 06410-3316 Ph: (203) 408-2462 | Complete Wound Care Llc 67 Masonic Ave Ste 2400 Wallingford CT 06492-3099 Ph: (203) 408-2462 |
| NPI Number | 1033801568 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Medicare PECOS PAC ID | 8729445580 |
|---|---|
| Medicare Enrollment ID | O20230609000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033801568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Adrian Kenneth Wyllie |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1407234685 PECOS PAC ID: 7719291525 Enrollment ID: I20170810001282 |
| Provider Name | Heather Lee Eckenrode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194242008 PECOS PAC ID: 7012252547 Enrollment ID: I20210405000330 |
| Provider Name | Abhinit Drupad Shah |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1801423207 PECOS PAC ID: 7719337922 Enrollment ID: I20240411001063 |
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