MEDICARE: COMPASSIONATE CARE HOSPICE OF MISSOURI 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1811154107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CARE HOSPICE OF MISSOURI LLC

Provider Business Mailing Address
First Line	:	600 HIGHLAND DR
Second Line	:	SUITE 624
City	:	WESTAMPTON
State	:	NJ
Zip	:	08060-5120
Country	:	US
Telephone Number	:	609-267-1178
Fax Number	:	609-267-3499

Provider Business Practice Location Address
First Line	:	1322 BAUR BOULEVARD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132
Country	:	US
Telephone Number	:	201-919-4905
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	JUDITH GREY
Credential	:	MPA RN C
Telephone Number	:	973-402-4712

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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