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Organization
WOUND PROS SOUTH CAROLINA
Active
Organization
WOUND PROS SOUTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OWEN BERNARDO ELLINGTON MD (PRESIDENT)
(713) 304-4227
Entity
Organization
Contact information
Practice address
528 BROAD ST STE 102, SUMTER, SC 29150-3368
(323) 480-4075
Mailing address
5901 W CENTURY BLVD STE 750, LOS ANGELES, CA 90045-5443
(323) 480-4075
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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