MEDICARE: COMPASION, LLC

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	251S00000X	Community/Behavioral Health Agency	1286-02-014	VA

General Provider Information

NPI Number	:	1427359827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASION, LLC

Provider Business Mailing Address
First Line	:	1600 E LITTLE CREEK RD
Second Line	:	SUITE 304
City	:	NORFOLK
State	:	VA
Zip	:	23518-4136
Country	:	US
Telephone Number	:	757-581-3896
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 E LITTLE CREEK RD
Second Line	:	SUITE 304
City	:	NORFOLK
State	:	VA
Zip	:	23518-4136
Country	:	US
Telephone Number	:	757-581-3896
Fax Number	:

Authorized Official
Title or Position	:	HUMAN RESOURCE DIRECTOR
Name	:	CARMALITA KOVACH-WATTS
Credential	:
Telephone Number	:	757-581-3896

Provider Enumeration Date	:	11/16/2010
Last Update Date	:	11/16/2010

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