Healthcare Provider Details

I. General information

NPI: 1073439659
Provider Name (Legal Business Name): COMPASSION WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1858 MILLSTREAM HOLW
CONYERS GA
30012-3504
US

IV. Provider business mailing address

1858 MILLSTREAM HOLW
CONYERS GA
30012-3504
US

V. Phone/Fax

Practice location:
  • Phone: 912-220-2838
  • Fax:
Mailing address:
  • Phone: 912-220-2838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TONIKA PHILLIPS
Title or Position: OWNER
Credential: RN
Phone: 912-220-2838