Wound Company Provider Group, P.A.

LBN: Wound Company Provider Group, P.A.
Wound Company Provider Group, P.A. is an health care organization with primary practice located at 2240 Drew Ave S , Minneapolis MN 55416-3646. The organization recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Continence Care, Nursing Service Providers / Enterostomal Therapy, Nursing Service Providers / Wound Care. Nursing Service Providers / Wound Care is the primary health care specialty. Wound Company Provider Group, P.A. can be contacted via phone (858) 774-6305, or through Jolly, Brantley Tilman via phone (703) 447-6897.

Contact Information

Primary practice address
2240 Drew Ave S Minneapolis MN 55416-3646
Phone: (858) 774-6305
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jolly, Brantley Tilman Doctor of Medicine (MD)
Phone: (703) 447-6897

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Continence Care 163WC2100X
Nursing Service Providers / Enterostomal Therapy 163WE0900X
Nursing Service Providers / Wound Care 163WW0000X

Profile Details

NPI number 1225749542
LBN Legal business name Wound Company Provider Group, P.A.
DBA Doing business as
Authorized official Jolly, Brantley Tilman Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 7th, 2022
Last updated Dec 7th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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