MEDICARE: COMPASSIONATE CARE CLINIC 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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689462079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CARE CLINIC LLC

Provider Business Mailing Address
First Line	:	PO BOX 58
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-0058
Country	:	US
Telephone Number	:	731-438-3090
Fax Number	:	731-256-0757

Provider Business Practice Location Address
First Line	:	60 BRAZELTON ST UNIT 6
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-3080
Country	:	US
Telephone Number	:	731-607-2388
Fax Number	:

Authorized Official
Title or Position	:	APRN
Name	:	BRANDY ROGERS
Credential	:	APRN
Telephone Number	:	731-607-2388

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	12/17/2025

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Directions to “COMPASSIONATE CARE CLINIC LLC ” Practice Location

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