Wellspring Wound Care, Llc | |
913 S College Rd Ste 216 Lafayette LA 70503-3062 | |
(337) 278-5605 | |
(713) 510-1548 |
Full Name | Wellspring Wound Care, Llc |
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Speciality | General Practice |
Location | 913 S College Rd Ste 216, Lafayette, Louisiana |
Authorized Official Name and Position | Leonard Carl Rainey (PRESIDENT/COO) |
Authorized Official Contact | 3372785605 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wellspring Wound Care, Llc 913 S College Rd Ste 216 Lafayette LA 70503-3062 Ph: (337) 278-5605 | Wellspring Wound Care, Llc 913 S College Rd Ste 216 Lafayette LA 70503-3062 Ph: (337) 278-5605 |
NPI Number | 1508629122 |
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Provider Enumeration Date | 02/05/2024 |
Last Update Date | 02/05/2024 |
Medicare PECOS PAC ID | 0143660217 |
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Medicare Enrollment ID | O20240507000271 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508629122 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Zebediah A Stearns |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487718128 PECOS PAC ID: 8729982202 Enrollment ID: I20031125000864 |
Provider Name | Racheal Bailey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033522131 PECOS PAC ID: 3274750054 Enrollment ID: I20140819001882 |
Provider Name | Chad Bailey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821487380 PECOS PAC ID: 5193040368 Enrollment ID: I20150210001023 |
Provider Name | Steven Kenney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568912608 PECOS PAC ID: 8628353414 Enrollment ID: I20170317000238 |
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