MEDICARE: COMPASSUS BSMH HAMPTON ROADS HHA 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1508684457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSUS BSMH HAMPTON ROADS HHA LLC

Provider Business Mailing Address
First Line	:	10 CADILLAC DR STE 400
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-1001
Country	:	US
Telephone Number	:	615-637-9163
Fax Number	:	615-373-4457

Provider Business Practice Location Address
First Line	:	7007 HARBOUR VIEW BLVD STE 114
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23435-3657
Country	:	US
Telephone Number	:	757-889-4663
Fax Number	:

Authorized Official
Title or Position	:	SVP, CHIEF LEGAL OFFICER
Name	:	RUSSELL ADKINS
Credential	:
Telephone Number	:	615-926-0340

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	09/30/2024

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