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Contact Information

WOUND COMPANY PROVIDER GROUP, P.A.
2240 DREW AVE S
MINNEAPOLIS, MN55416-3646
 Phone: 858-774-6305
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Wound Care

163WW0000X
 

Continence Care

163WC2100X
 

Enterostomal Therapy

163WE0900X
Indicates primary specialty

NPI Profile & details for WOUND COMPANY PROVIDER GROUP, P.A.

NPI Number 1225749542
LBN Legal business name WOUND COMPANY PROVIDER GROUP, P.A.
Authorized official BRANTLEY JOLLY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/07/2022
Last updated 12/07/2022 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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