Provider Demographics
NPI:1902339831
Name:CJMH, LLC
Entity Type:Organization
Organization Name:CJMH, LLC
Other - Org Name:ARKANSAS EYE SITE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRI
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNDON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:870-333-1087
Mailing Address - Street 1:800 PROFESSIONAL ACRES DR.
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401
Mailing Address - Country:US
Mailing Address - Phone:870-333-1087
Mailing Address - Fax:870-333-1088
Practice Address - Street 1:102 PLANTATION DR.
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:AR
Practice Address - Zip Code:72370
Practice Address - Country:US
Practice Address - Phone:870-563-3596
Practice Address - Fax:870-563-1239
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CJMH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR424757ZP7WMedicare PIN
AR366842ZP7WMedicare PIN
AR366842ZP7WMedicare PIN
AR424757ZP7WMedicare PIN