Provider Demographics
NPI:1518417773
Name:COMPASSUS OP OF OHIO LLC
Entity Type:Organization
Organization Name:COMPASSUS OP OF OHIO LLC
Other - Org Name:COMPASSUS - WESTERN OHIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-309-5668
Mailing Address - Street 1:10 CADILLAC DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1001
Mailing Address - Country:US
Mailing Address - Phone:615-377-7022
Mailing Address - Fax:615-373-4457
Practice Address - Street 1:11311 CORNELL PARK DR
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-619-3700
Practice Address - Fax:888-810-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
361633Medicare Oscar/Certification