MEDICARE: COMPASSUS OP OF MISSOURI LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1851835250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSUS OP OF MISSOURI LLC

Provider Business Mailing Address
First Line	:	10 CADILLAC DR STE 400
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-1001
Country	:	US
Telephone Number	:	615-377-7022
Fax Number	:	615-373-4457

Provider Business Practice Location Address
First Line	:	11872 WESTLINE INDUSTRIAL DR STE 160
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-3331
Country	:	US
Telephone Number	:	314-592-3670
Fax Number	:	314-592-3681

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANTHONY JAMES
Credential	:
Telephone Number	:	615-224-8028

Provider Enumeration Date	:	12/05/2016
Last Update Date	:	07/21/2022

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