Provider Demographics
NPI:1811900871
Name:ABSOLUTE VISION CARE PC
Entity type:Organization
Organization Name:ABSOLUTE VISION CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCCAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:641-414-7799
Mailing Address - Street 1:1367 TIMBERLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-8193
Mailing Address - Country:US
Mailing Address - Phone:641-414-7799
Mailing Address - Fax:
Practice Address - Street 1:1367 TIMBERLAKE AVE
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-8193
Practice Address - Country:US
Practice Address - Phone:641-414-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02337152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
23187OtherTRICARE AT VALLEY WEST
23187OtherWELLMARK AT VALLEY WEST
23189OtherTRICARE AT MERLE HAY
IA2337OtherEYE MED
42585OtherSPECTARA
41142OtherAVESIS
23189OtherWELLMARK AT MERLE HAY
23189OtherTRICARE AT MERLE HAY
IA2337OtherEYE MED
I19545Medicare PIN