MEDICARE: COMPASS ROSE EDUCATION, INC.

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1760036529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASS ROSE EDUCATION, INC.

Provider Business Mailing Address
First Line	:	3838 N CENTRAL AVE STE 1600
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-1950
Country	:	US
Telephone Number	:	800-354-4881
Fax Number	:	602-926-2445

Provider Business Practice Location Address
First Line	:	8005 OUTER CIRCLE RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78235-5203
Country	:	US
Telephone Number	:	210-540-9265
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	MICHELLE GENTRY
Credential	:
Telephone Number	:	800-354-4881

Provider Enumeration Date	:	07/30/2019
Last Update Date	:	07/30/2019

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