Provider Demographics
NPI:1649506049
Name:OPHTHALMIC NURSING CARE OF ARIZONA INC.
Entity type:Organization
Organization Name:OPHTHALMIC NURSING CARE OF ARIZONA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-228-8921
Mailing Address - Street 1:2202 E BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4721
Mailing Address - Country:US
Mailing Address - Phone:602-279-9657
Mailing Address - Fax:602-285-1518
Practice Address - Street 1:2202 E BELMONT AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4721
Practice Address - Country:US
Practice Address - Phone:602-279-9657
Practice Address - Fax:602-285-1518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN028029163WH0200X, 163WX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WX1100XNursing Service ProvidersRegistered NurseOphthalmicGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty