Healthcare Provider Details

I. General information

NPI: 1093493116
Provider Name (Legal Business Name): COMPASSION AT HEART HOMEHEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9506 ARDWICK ARDMORE RD
SPRINGDALE MD
20774-2511
US

IV. Provider business mailing address

9506 ARDWICK ARDMORE RD
SPRINGDALE MD
20774-2511
US

V. Phone/Fax

Practice location:
  • Phone: 240-486-7284
  • Fax: 301-576-5347
Mailing address:
  • Phone: 240-486-7284
  • Fax: 301-576-5347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DONYA BUTLER
Title or Position: CCMA/CNA
Credential:
Phone: 240-486-7284