Provider Demographics
NPI:1144190422
Name:WOUND100 MEDICAL ALABAMA LLC
Entity type:Organization
Organization Name:WOUND100 MEDICAL ALABAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-400-5303
Mailing Address - Street 1:19681 CHICAGO ST APT A
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-6525
Mailing Address - Country:US
Mailing Address - Phone:402-651-6040
Mailing Address - Fax:
Practice Address - Street 1:4000 EAGLE POINT CORPORATE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-1900
Practice Address - Country:US
Practice Address - Phone:402-651-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty