Organization
GENESIS WOUND CARE OF LAS VEGAS, 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
2410 FIRE MESA ST, SUITE 160, LAS VEGAS, NV 89128-9016
(702) 518-1534
(702) 931-3944
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
—
—
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
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