| Name: | Martin Wound Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 30 Jul 2019 (5 years ago) |
| Entity Number: | 000-583-177 |
| Register Number: | 000583177 |
| ZIP code: | 35976 |
| County: | Marshall |
| Place of Formation: | Marshall County |
| Registered Office Street Address: | 5903 SPRING CREEK DRIVEGUNTERSVILLE, AL 35976 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629625041 | 2019-08-20 | 2020-08-28 | 5903 SPRING CIR, GUNTERSVILLE, AL, 359762811, US | 11491 US HIGHWAY 431, ALBERTVILLE, AL, 359500136, US | |||||||||||||||||||||||||||
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| Phone | +1 256-505-6826 |
| Fax | 2565712862 |
Authorized person
| Name | SYDNEY JONES |
| Role | BILLING DIRECTOR |
| Phone | 2565056826 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | GROUP MEDICARE NUMBER |
| Number | 2796 |
| State | AL |
| Issuer | MEDICAID |
| Number | 238173 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MARTIN, DONALD C JR | Agent | 5903 SPRING CIRCLEGUNTERSVILLE, AL 35976 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
