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Organization
GENESIS WOUND CARE OF POOLER, LLC
Active
Organization
GENESIS WOUND CARE OF POOLER, LLC
Active
Parent organization
GENESIS WOUNDCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS WOUNDCARE
Authorized official
JAMES THOMAS O'DARE III (PRINICIPAL)
(856) 335-5025
Entity
Organization
Contact information
Practice address
1000 TOWNE CENTER BLVD, BUILDING 400, POOLER, GA 31322-4052
(912) 662-0223
(912) 662-0224
Mailing address
575 N ROUTE 73, SUITE A6, WEST BERLIN, NJ 08091-9289
(856) 335-5025
(856) 213-9269
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
NULL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
332BX2000X
Oxygen Equipment & Supplies (DME)
—
NULL
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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