Provider Demographics
NPI:1871328310
Name:WOUNDGUARD
Entity type:Organization
Organization Name:WOUNDGUARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-910-7038
Mailing Address - Street 1:32173 FIRESIDE DR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5154
Mailing Address - Country:US
Mailing Address - Phone:909-732-8527
Mailing Address - Fax:
Practice Address - Street 1:150 S PINE ISLAND RD STE 415
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2667
Practice Address - Country:US
Practice Address - Phone:833-752-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty