1134101256 NPI number — CAMPUS EYE GROUP ASC, LLC

Table of content: (NPI 1134101256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134101256 NPI number — CAMPUS EYE GROUP ASC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAMPUS EYE GROUP ASC, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134101256
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 WHITEHORSE HAMILTON SQUARE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMILTON SQUARE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08690-3536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-587-2020
Provider Business Mailing Address Fax Number:
609-588-9545

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 WHITEHORSE HAMILTON SQUARE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON SQ
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08690-3536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-587-2020
Provider Business Practice Location Address Fax Number:
609-588-9545
Provider Enumeration Date:
11/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
VOSS
Authorized Official First Name:
MAUREEN
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
INSURANCE/BILLING SPECIALIST
Authorized Official Telephone Number:
609-587-2020

Provider Taxonomy Codes

  • Taxonomy code: 261QS0132X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001327000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 003178 . This is a "WELLCHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1053208 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01000313000 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0206675003 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: IL9975 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001372000 . This is a "IBC/PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 382411 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68834 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 311026 . This is a "HORIZON BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5206006 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: ANC1416 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com