Healthcare Provider Details

I. General information

NPI: 1689462079
Provider Name (Legal Business Name): COMPASSIONATE CARE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 BRAZELTON ST UNIT 6
SAVANNAH TN
38372-3080
US

IV. Provider business mailing address

PO BOX 58
SAVANNAH TN
38372-0058
US

V. Phone/Fax

Practice location:
  • Phone: 731-607-2388
  • Fax:
Mailing address:
  • Phone: 731-438-3090
  • Fax: 731-256-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRANDY ROGERS
Title or Position: APRN
Credential: APRN
Phone: 731-607-2388