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BLUE AGAVE WOUND CARE SOLUTIONS LLC

Wound Care

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Contact Information

BLUE AGAVE WOUND CARE SOLUTIONS LLC
10109 LAKE CREEK PKWY UNIT 170434
AUSTIN, TX  78717-0119
 Phone: 844-275-3822
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Wound Care

 163WW0000X
 

Home Health

 364SH0200X 89 Certified Clinical Nurse Specialist
 

Home Health

 163WH0200X
 

Home Health Aide

 374U00000X
 

Nurse Practitioner

 363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for BLUE AGAVE WOUND CARE SOLUTIONS LLC

NPI Number 1851869234
LBN Legal business name BLUE AGAVE WOUND CARE SOLUTIONS LLC
Authorized official RICHARD CARNEY - (MEMBER LLC)
Entity Organization
Organization subpart 1 No
Enumeration date 11/05/2018
Last updated 11/05/2018 - About 8 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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