Provider Demographics
NPI:1316534506
Name:DR. PENNY'S EYE CARE INC.
Entity Type:Organization
Organization Name:DR. PENNY'S EYE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRESHOUR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-940-9796
Mailing Address - Street 1:163 GLENN HILL DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-9405
Mailing Address - Country:US
Mailing Address - Phone:501-940-9796
Mailing Address - Fax:
Practice Address - Street 1:5501 S OLIVE ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7607
Practice Address - Country:US
Practice Address - Phone:870-536-2200
Practice Address - Fax:870-534-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty