Provider Demographics
NPI:1508273038
Name:NWO COMPASSION CARE CHARITIES
Entity Type:Organization
Organization Name:NWO COMPASSION CARE CHARITIES
Other - Org Name:BOUTIQUE FABULOUS CANCER & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-708-3994
Mailing Address - Street 1:344 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-3009
Mailing Address - Country:US
Mailing Address - Phone:419-708-3994
Mailing Address - Fax:
Practice Address - Street 1:908 HUNTERS RUN
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5497
Practice Address - Country:US
Practice Address - Phone:419-708-3994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier