Provider Demographics
NPI:1013085745
Name:COMPASSIONATE HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:COMPASSIONATE HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-593-2312
Mailing Address - Street 1:1717 E GENTRY PKWY
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-3514
Mailing Address - Country:US
Mailing Address - Phone:903-593-2312
Mailing Address - Fax:903-593-2187
Practice Address - Street 1:1717 E GENTRY PKWY
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-3514
Practice Address - Country:US
Practice Address - Phone:903-593-2312
Practice Address - Fax:903-593-2187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003182251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458261Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER