Provider Demographics
NPI:1306403613
Name:COMPASSIONATE CARE PHYSICIANS LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CARE PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FANUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-823-0023
Mailing Address - Street 1:9 MILL AND MAIN PL STE 101
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-2651
Mailing Address - Country:US
Mailing Address - Phone:978-823-0023
Mailing Address - Fax:978-823-0000
Practice Address - Street 1:9 MILL AND MAIN PL STE 101
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-2651
Practice Address - Country:US
Practice Address - Phone:978-823-0023
Practice Address - Fax:978-823-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care