Healthcare Provider Details

I. General information

NPI: 1023320595
Provider Name (Legal Business Name): COMPASS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST ROOM C2C130
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

2400 YORKMONT RD
CHARLOTTE NC
28217-4511
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-6979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number987244
License Number StateCA

VIII. Authorized Official

Name: MEGAN SEWARDS
Title or Position: REGISTERED DIETITIAN
Credential:
Phone: 310-736-5209