| Tripleheart Wound Care | |
|
79 Pembroke Pt Centerville GA 31028-8043 | |
| (636) 290-5223 | |
| (912) 999-3293 |
| Full Name | Tripleheart Wound Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 79 Pembroke Pt, Centerville, Georgia |
| Authorized Official Name and Position | Chandani Patel (OWNER) |
| Authorized Official Contact | 6362905223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tripleheart Wound Care 79 Pembroke Pt Centerville GA 31028-8043 Ph: (636) 290-5223 | Tripleheart Wound Care 79 Pembroke Pt Centerville GA 31028-8043 Ph: (636) 290-5223 |
| NPI Number | 1558232942 |
|---|---|
| Provider Enumeration Date | 09/17/2025 |
| Last Update Date | 09/17/2025 |
| Certification Date | 09/17/2025 |
| Medicare PECOS PAC ID | 4284124801 |
|---|---|
| Medicare Enrollment ID | O20251103002954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558232942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Julia Paolino-richardson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780074039 PECOS PAC ID: 2668777541 Enrollment ID: I20160629001646 |
| Provider Name | Sandeep D Goswami |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750152518 PECOS PAC ID: 1052800075 Enrollment ID: I20251030000751 |
Southern Heritage Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 Carl Vinson Pkwy, Centerville, GA 31028 Phone: 478-922-6380 |