MEDICARE: COMPASSIONATE COMPANION CARE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	0068351	NY

General Provider Information

NPI Number	:	1316480353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE COMPANION CARE, PLLC

Provider Business Mailing Address
First Line	:	825 W WATER ST
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14905-2330
Country	:	US
Telephone Number	:	607-738-4792
Fax Number	:	607-732-7301

Provider Business Practice Location Address
First Line	:	204 HENDY CREEK RD
Second Line	:
City	:	PINE CITY
State	:	NY
Zip	:	14871-9760
Country	:	US
Telephone Number	:	607-732-7310
Fax Number	:	607-732-7301

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARI ANN DELANEY
Credential	:	DVM
Telephone Number	:	607-732-7310

Provider Enumeration Date	:	11/23/2016
Last Update Date	:	11/23/2016

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