Provider Demographics
NPI:1003342064
Name:COMPASS PRIMARY CARE INC
Entity Type:Organization
Organization Name:COMPASS PRIMARY CARE INC
Other - Org Name:COMPREHENSIVE PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SASI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-953-1753
Mailing Address - Street 1:106 JAVIT CT
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2443
Mailing Address - Country:US
Mailing Address - Phone:330-953-1753
Mailing Address - Fax:330-953-1758
Practice Address - Street 1:106 JAVIT CT
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2443
Practice Address - Country:US
Practice Address - Phone:330-953-1753
Practice Address - Fax:330-953-1758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.14139363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty