Healthcare Provider Details

I. General information

NPI: 1891920211
Provider Name (Legal Business Name): COMPASSION HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2009
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19409 US HWY 271
SPIRO OK
74959
US

IV. Provider business mailing address

19409 US HWY 271
SPIRO OK
74959
US

V. Phone/Fax

Practice location:
  • Phone: 918-962-4545
  • Fax: 918-962-4061
Mailing address:
  • Phone: 918-962-4545
  • Fax: 918-962-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOK

VIII. Authorized Official

Name: DEREK LANE
Title or Position: SECRETARY/TREASURER
Credential:
Phone: 918-448-7336