| Integrated Wound Care Management Ohio Llc | |
|
2770 Clime Rd Columbus OH 43223-3626 | |
| (732) 451-4318 | |
| Not Available |
| Full Name | Integrated Wound Care Management Ohio Llc |
|---|---|
| Speciality | General Practice |
| Location | 2770 Clime Rd, Columbus, Ohio |
| Authorized Official Name and Position | Diane Lusas (MEMBER) |
| Authorized Official Contact | 7324514318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Wound Care Management Ohio Llc 492c Cedar Ln Ste 514 Teaneck NJ 07666-1713 Ph: () - | Integrated Wound Care Management Ohio Llc 2770 Clime Rd Columbus OH 43223-3626 Ph: (732) 451-4318 |
| NPI Number | 1346708997 |
|---|---|
| Provider Enumeration Date | 03/03/2019 |
| Last Update Date | 03/03/2019 |
| Medicare PECOS PAC ID | 1557602851 |
|---|---|
| Medicare Enrollment ID | O20190415002848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346708997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Bruce S Kay |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841310612 PECOS PAC ID: 4587691704 Enrollment ID: I20050720000062 |
| Provider Name | Diane Lusas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730475658 PECOS PAC ID: 9032430640 Enrollment ID: I20240327002381 |
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