MEDICARE: COMPASSION HOME CARE

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	253Z00000X	In Home Supportive Care Agency	HC4017	NC

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	:	1992138952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSION HOME CARE

Provider Business Mailing Address
First Line	:	122 A NORTH RUTHERFORD STREET
Second Line	:
City	:	WADESBORO
State	:	NC
Zip	:	28170-2131
Country	:	US
Telephone Number	:	704-694-2028
Fax Number	:	704-694-2031

Provider Business Practice Location Address
First Line	:	122 A NORTH RUTHERFORD STREET
Second Line	:
City	:	WADESBORO
State	:	NC
Zip	:	28170-2131
Country	:	US
Telephone Number	:	704-694-2028
Fax Number	:	704-694-2031

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	ELLA STURDIVANT PERRY
Credential	:
Telephone Number	:	704-694-2028

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	08/14/2013

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Directions to “COMPASSION HOME CARE ” Practice Location

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