Provider Demographics
NPI:1891920211
Name:COMPASSION HOME CARE, INC.
Entity Type:Organization
Organization Name:COMPASSION HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-448-7336
Mailing Address - Street 1:19409 US HWY 271
Mailing Address - Street 2:
Mailing Address - City:SPIRO
Mailing Address - State:OK
Mailing Address - Zip Code:74959
Mailing Address - Country:US
Mailing Address - Phone:918-962-4545
Mailing Address - Fax:918-962-4061
Practice Address - Street 1:19409 US HWY 271
Practice Address - Street 2:
Practice Address - City:SPIRO
Practice Address - State:OK
Practice Address - Zip Code:74959
Practice Address - Country:US
Practice Address - Phone:918-962-4545
Practice Address - Fax:918-962-4061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377740Medicare UPIN