Provider Demographics
NPI:1548591118
Name:CAMP EYE CARE CLINIC, INC.
Entity Type:Organization
Organization Name:CAMP EYE CARE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:501-305-4300
Mailing Address - Street 1:2601 E RACE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4774
Mailing Address - Country:US
Mailing Address - Phone:501-305-4300
Mailing Address - Fax:501-305-4320
Practice Address - Street 1:2601 E RACE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4774
Practice Address - Country:US
Practice Address - Phone:501-305-4300
Practice Address - Fax:501-305-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2342332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR115915722Medicaid
AR5330190001Medicare UPIN
AR115915722Medicaid
ART84948Medicare UPIN