# GENESIS WOUND CARE OF LAS VEGAS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GENESIS WOUNDCARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750741740
- **Legal business name:** GENESIS WOUNDCARE
- **Authorized official:** JAMES THOMAS O'DARE III (PRINICIPAL)
- **Authorized official phone:** (856) 335-5025

## Contact information

- **Practice address:** 2410 FIRE MESA ST, SUITE 160, LAS VEGAS, NV 89128-9016
- **Practice address phone:** (702) 518-1534
- **Practice address fax:** (702) 931-3944
- **Mailing address:** 575 N ROUTE 73, SUITE A6, WEST BERLIN, NJ 08091-9289
- **Mailing address phone:** (856) 335-5025
- **Mailing address fax:** (856) 213-9269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | — | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | — | — |

## Other

- **Enumeration date:** 03/03/2016
- **Last updated:** 03/03/2016