Organization
COMPASS HOME DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY GRAVES (CHIEF OPERATING OFFICER)
(772) 349-3882
Entity
Organization
Contact information
Practice address
178 WEST CAMBELLTON ST, FAIRBURN, GA 30213
(772) 349-3882
Mailing address
1394 E 23RD ST, BROOKLYN, NY 11210-5113
(772) 349-3882
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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