| NPI | 1154860310 |
|---|---|
| Other Name | COMPASSIONATE CARE PEDS |
| Entity Type | Organization |
| Authorized Contact | LUIS A MATOS Supervising Physician 276-252-1948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101056392) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: VA 0101056392) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-04-21 |