Provider Demographics
NPI:1235958950
Name:I HEAL WOUNDS
Entity type:Organization
Organization Name:I HEAL WOUNDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:MANNING
Authorized Official - Last Name:BASS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:240-521-6092
Mailing Address - Street 1:509 QUINCE ORCHARD RD # 112
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1435
Mailing Address - Country:US
Mailing Address - Phone:240-521-6092
Mailing Address - Fax:
Practice Address - Street 1:20307 GRAZING WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-1211
Practice Address - Country:US
Practice Address - Phone:240-521-6092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty