Genesis Wound Care of Las Vegas, LLC

NPI #1750741740 in Las Vegas, Nevada

Provider Information

NPI Number: 1750741740
Entity Type: Organization
Organization Name: Genesis Wound Care of Las Vegas, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: GENESIS WOUNDCARE
Primary Specialty: Preventive Medicine - Undersea and Hyperbaric Medicine
Enumeration Date: Mar 3, 2016
Last Updated: Mar 3, 2016

Practice Location

Address: 2410 FIRE MESA ST
Address 2: SUITE 160
City: Las Vegas
State: Nevada
ZIP Code: 89128-9016
Phone: (702) 518-1534

Authorized Official

Name: JAMES THOMAS O'DARE III
Title: PRINICIPAL
Phone: (856) 335-5025

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery	213ES0103X
Durable Medical Equipment & Medical Supplies	332B00000X
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies — Oxygen Equipment & Supplies	332BX2000X
Preventive Medicine - Undersea and Hyperbaric Medicine — Undersea and Hyperbaric Medicine	2083P0011X	Primary

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