| Compass Primary Care LLC | |
|
1720 Phoenix Blvd Ste 700 College Park GA 30349-5596 | |
| (470) 369-7800 | |
| (470) 369-7801 |
| Full Name | Compass Primary Care LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1720 Phoenix Blvd Ste 700, College Park, Georgia |
| Authorized Official Name and Position | Karen Luster (OWNER) |
| Authorized Official Contact | 4703697800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compass Primary Care LLC 1720 Phoenix Blvd Ste 700 College Park GA 30349-5596 Ph: (470) 369-7800 | Compass Primary Care LLC 1720 Phoenix Blvd Ste 700 College Park GA 30349-5596 Ph: (470) 369-7800 |
| NPI Number | 1508340860 |
|---|---|
| Provider Enumeration Date | 09/21/2018 |
| Last Update Date | 05/30/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 4789920885 |
|---|---|
| Medicare Enrollment ID | O20190110001872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508340860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Karen Y Luster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043322753 PECOS PAC ID: 7012953284 Enrollment ID: I20050629000002 |
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