| Dermacore Wound Care | |
|
871 Coronado Center Dr Henderson NV 89052-3977 | |
| (702) 660-0809 | |
| (702) 659-8039 |
| Full Name | Dermacore Wound Care |
|---|---|
| Speciality | General Practice |
| Location | 871 Coronado Center Dr, Henderson, Nevada |
| Authorized Official Name and Position | Michelle Labao (DIRECTOR) |
| Authorized Official Contact | 7026600809 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dermacore Wound Care 871 Coronado Center Dr Henderson NV 89052-3977 Ph: (702) 660-0809 | Dermacore Wound Care 871 Coronado Center Dr Henderson NV 89052-3977 Ph: (702) 660-0809 |
| NPI Number | 1760340756 |
|---|---|
| Provider Enumeration Date | 01/10/2026 |
| Last Update Date | 01/10/2026 |
| Certification Date | 01/10/2026 |
| Medicare PECOS PAC ID | 3678041522 |
|---|---|
| Medicare Enrollment ID | O20260508001216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760340756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Marissa Schanbacher Adolfo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700302791 PECOS PAC ID: 5991079568 Enrollment ID: I20180207002903 |
| Provider Name | Daniel L Hallman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427597079 PECOS PAC ID: 5799115135 Enrollment ID: I20200425000037 |
| Provider Name | Mia Laisa Thibault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144946013 PECOS PAC ID: 1951772698 Enrollment ID: I20230117002138 |
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