Compass Medical Center Snowflake, PLLC

Organization Active NPI General Practice Physician · Snowflake, AZ

NPI 1669936050 · NPPES record last updated Mar 19, 2024

Key facts

NPI
1669936050
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
COMPASS MEDICAL CENTER SNOWFLAKE, PLLC
Practice address
1300 S Main St
Snowflake, AZ 85937-5661
Phone
(928) 536-5525
NPI assigned
Jan 30, 2019
Organization subpart
No

Authorized official

Name
Justin Woodside
Title
Owner
Phone
(928) 536-5525

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AZ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190313002765 AZ Part B Supplier - Clinic/Group Practice 6608116405 Receives reassigned benefits from 3 practitioners
Practice locations: Snowflake, AZ
O20240403003707 AZ DME Supplier - Multi-Specialty - Physician 6608116405 Practice locations: Snowflake, AZ

National Provider Directory

Locations

1300 S Main St
#5662
Snowflake, AZ 85937

1300 S Main St
Ste A
Snowflake, AZ 85937
Phone (928) 536-5525

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

1300 S Main St
Snowflake, AZ 85937-5661

Mailing address

1300 S Main St
Snowflake, AZ 85937-5661
Phone (928) 536-5525

Other providers in Snowflake, AZ

All providers in Snowflake, AZ · General Practice Physician in Arizona

Sources for this page

Verify at the official NPI Registry.