Organization · NPI-2

Eye Care Optical

Eyewear Supplier (Equipment, not the service) · Little Rock, AR

NPI number1104961911
StatusActive
Last updated in NPPESJan 23, 2020

Details

NPI
1104961911
Entity type
Organization (NPI-2)
Legal business name
Eye Care Optical
Organization subpart
No
Enumeration date
Feb 20, 2007
Certification date
Jan 23, 2020
Last updated
Jan 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332H00000X Eyewear Supplier (Equipment, not the service)–ARYes

Practice location

9800 Baptist Health Dr Ste 301
Little Rock, AR 72205-6230

Phone 501-225-4507 · Fax 501-225-9299

Mailing address

9800 Baptist Health Drive Suite 301
Little Rock, AR 72205

Phone 501-225-4507 · Fax 501-225-9299

Authorized official

Kennan Artimus Doan
Part Owner
5012254507

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