Provider Demographics
NPI:1689118085
Name:COMPASSUS OP OF ARIZONA LLC
Entity Type:Organization
Organization Name:COMPASSUS OP OF ARIZONA LLC
Other - Org Name:COMPASSUS - PHOENIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-224-8028
Mailing Address - Street 1:3003 N CENTRAL AVE
Mailing Address - Street 2:STE 800
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2902
Mailing Address - Country:US
Mailing Address - Phone:602-749-5900
Mailing Address - Fax:602-749-5999
Practice Address - Street 1:3003 N CENTRAL AVE
Practice Address - Street 2:STE 800
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2902
Practice Address - Country:US
Practice Address - Phone:602-749-5900
Practice Address - Fax:602-749-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z132047Medicare Oscar/Certification