Provider Demographics
NPI:1740152511
Name:PERRY HOME WOUND CARE LLC
Entity type:Organization
Organization Name:PERRY HOME WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEPTHE
Authorized Official - Middle Name:
Authorized Official - Last Name:NKWANMEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:478-442-9926
Mailing Address - Street 1:211 RUSTY PLOW LN
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-9870
Mailing Address - Country:US
Mailing Address - Phone:478-442-9926
Mailing Address - Fax:
Practice Address - Street 1:211 RUSTY PLOW LN
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-9870
Practice Address - Country:US
Practice Address - Phone:478-442-9926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care