Provider Demographics
NPI:1053743997
Name:CENTER FOR WOUND SCIENCE AND HEALING
Entity type:Organization
Organization Name:CENTER FOR WOUND SCIENCE AND HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGUILLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-587-7707
Mailing Address - Street 1:495 N 13TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-1317
Mailing Address - Country:US
Mailing Address - Phone:973-497-7770
Mailing Address - Fax:973-497-7785
Practice Address - Street 1:495 NORTH 13TH STREET, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107
Practice Address - Country:US
Practice Address - Phone:973-497-7770
Practice Address - Fax:973-497-7785
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBUS LTACH HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access