Provider Demographics
NPI:1700169760
Name:ARIZONA MOBILE WOUND CARE SERVICES, PLLC
Entity type:Organization
Organization Name:ARIZONA MOBILE WOUND CARE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SOLANGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE-MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:602-588-7000
Mailing Address - Street 1:PO BOX 5520
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85312-5520
Mailing Address - Country:US
Mailing Address - Phone:602-588-7000
Mailing Address - Fax:602-588-3001
Practice Address - Street 1:11615 N 39TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3002
Practice Address - Country:US
Practice Address - Phone:602-588-7000
Practice Address - Fax:602-588-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty