Healthcare Provider Details

I. General information

NPI: 1306607353
Provider Name (Legal Business Name): COMPASSION FORCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1679 MAGNOLIA DR
PRENTISS MS
39474-9008
US

IV. Provider business mailing address

PO BOX 4486
BROOKHAVEN MS
39603-6486
US

V. Phone/Fax

Practice location:
  • Phone: 601-550-7403
  • Fax:
Mailing address:
  • Phone: 601-550-7403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: PACHUA ASKUWHETEAU
Title or Position: OWNER
Credential:
Phone: 601-550-8905