Provider Demographics
NPI:1548002942
Name:ADVANCED WOUNDCARE SPECIALISTS LLC
Entity type:Organization
Organization Name:ADVANCED WOUNDCARE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:318-229-5055
Mailing Address - Street 1:104 HIDDEN PATH DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-2202
Mailing Address - Country:US
Mailing Address - Phone:318-229-5055
Mailing Address - Fax:
Practice Address - Street 1:223 FAIRBURN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BENTON
Practice Address - State:LA
Practice Address - Zip Code:71006
Practice Address - Country:US
Practice Address - Phone:318-229-5055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty