Provider Demographics
NPI:1073799185
Name:ANTHONY F. CAMPANA
Entity Type:Organization
Organization Name:ANTHONY F. CAMPANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:CAMPANA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-327-1938
Mailing Address - Street 1:1202 CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3836
Mailing Address - Country:US
Mailing Address - Phone:570-327-1938
Mailing Address - Fax:
Practice Address - Street 1:1202 CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3836
Practice Address - Country:US
Practice Address - Phone:570-327-1938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000364332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA043046Medicare PIN
PA0354700002Medicare NSC