Basic Information
Provider Information
NPI: 1588114839
EntityType: 2
ReplacementNPI:  
OrganizationName: COMPASSUS OP OF ALABAMA LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: COMPASSUS HOSPICE AND PALLIATIVE CARE-BIRMINGHAM
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10 CADILLAC DR STE 400
Address2:  
City: BRENTWOOD
State: TN
PostalCode: 370271001
CountryCode: US
TelephoneNumber: 6153777022
FaxNumber: 6153734457
Practice Location
Address1: 1900 INTERNATIONAL PARK DR STE 200
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352434217
CountryCode: US
TelephoneNumber: 2057307980
FaxNumber: 2059684072
Other Information
ProviderEnumerationDate: 10/11/2016
LastUpdateDate: 07/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ADKINS
AuthorizedOfficialFirstName: RUSSELL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SVP GENERAL COUNSEL
AuthorizedOfficialTelephone: 6153095668
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251G00000X  Y AgenciesHospice Care, Community Based 

No ID Information.


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