Provider Demographics
NPI:1639339468
Name:COMPASS ION LLC
Entity Type:Organization
Organization Name:COMPASS ION LLC
Other - Org Name:RELAX THE BACK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-477-1303
Mailing Address - Street 1:3916 CONCORD PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-1716
Mailing Address - Country:US
Mailing Address - Phone:302-477-1303
Mailing Address - Fax:302-477-1014
Practice Address - Street 1:3916 CONCORD PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1716
Practice Address - Country:US
Practice Address - Phone:302-477-1303
Practice Address - Fax:302-477-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE174400000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE5727900001Medicare PIN