| Champion Wound Solutions PLLC | |
|
201 W Kay St Dayton TX 77535-2256 | |
| (877) 258-6331 | |
| (718) 362-1651 |
| Full Name | Champion Wound Solutions PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 201 W Kay St, Dayton, Texas |
| Authorized Official Name and Position | Charlotte Rena Tenney (OWNER) |
| Authorized Official Contact | 8772586331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Champion Wound Solutions PLLC 612 Corporate Way Ste 2m Valley Cottage NY 10989-2027 Ph: (718) 362-1411 | Champion Wound Solutions PLLC 201 W Kay St Dayton TX 77535-2256 Ph: (877) 258-6331 |
| NPI Number | 1952199549 |
|---|---|
| Provider Enumeration Date | 04/25/2025 |
| Last Update Date | 04/25/2025 |
| Certification Date | 04/25/2025 |
| Medicare PECOS PAC ID | 7517485352 |
|---|---|
| Medicare Enrollment ID | O20250515002601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952199549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Charlotte Rena Tenney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225752231 PECOS PAC ID: 3971972878 Enrollment ID: I20221215003175 |
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