=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932695707
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMPASS HEALTHCARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2018
-----------------------------------------------------
Last Update Date | 07/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14192 NATIONAL RD SW
-----------------------------------------------------
City | ETNA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43068-3365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-800-1467
-----------------------------------------------------
Fax | 614-800-7892
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14192 NATIONAL RD SW
-----------------------------------------------------
City | ETNA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43068-3365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-800-1467
-----------------------------------------------------
Fax | 614-800-7892
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING MANAGER
-----------------------------------------------------
Name | MRS. CALI M SWISHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-800-1467
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------