Provider Demographics
NPI:1447232913
Name:CAMPUS EYE GROUP, LLC
Entity Type:Organization
Organization Name:CAMPUS EYE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICARE/CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-587-2020
Mailing Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3536
Mailing Address - Country:US
Mailing Address - Phone:609-587-2020
Mailing Address - Fax:609-588-9545
Practice Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-3536
Practice Address - Country:US
Practice Address - Phone:609-587-2020
Practice Address - Fax:609-588-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8330913Medicaid
NJ8330905Medicaid
NJ593899Medicare ID - Type Unspecified
NJ8330905Medicaid