Provider Demographics
NPI:1265847354
Name:COMPASSIONATE DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:COMPASSIONATE DIAGNOSTICS, LLC
Other - Org Name:CUTTING EDGE TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:DICKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:410-829-5580
Mailing Address - Street 1:1000 MIDWAY DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HARRINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19952-2448
Mailing Address - Country:US
Mailing Address - Phone:302-398-0888
Mailing Address - Fax:302-398-0889
Practice Address - Street 1:1000 MIDWAY DR
Practice Address - Street 2:SUITE 3
Practice Address - City:HARRINGTON
Practice Address - State:DE
Practice Address - Zip Code:19952-2448
Practice Address - Country:US
Practice Address - Phone:302-398-0888
Practice Address - Fax:302-398-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006413174400000X, 261QE0002X, 261QP3300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency CareGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1700801172OtherINDIVIDUAL NPI