Healthcare Provider Details

I. General information

NPI: 1629602099
Provider Name (Legal Business Name): COMPASSION NURSING & HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MCCULLOUGH DR STE 400
CHARLOTTE NC
28262-1336
US

IV. Provider business mailing address

301 MCCULLOUGH DR STE 400
CHARLOTTE NC
28262-1336
US

V. Phone/Fax

Practice location:
  • Phone: 704-909-2720
  • Fax: 704-909-2701
Mailing address:
  • Phone: 704-909-2720
  • Fax: 704-909-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARTU T. PELIMA
Title or Position: DIRECTOR
Credential: NP
Phone: 704-909-2720