David A. Fullenkamp,Od, Pc

LBN: David A. Fullenkamp,Od, Pc
David A. Fullenkamp,Od, Pc is an health care organization with primary practice located at 1111 N Meridian St , Portland IN 47371-1024. The organization recently has only one registered license in Suppliers / Eyewear Supplier (Equipment, not the service), which is considered as the primary health care specialty. David A. Fullenkamp,Od, Pc can be contacted via phone (260) 726-4210, or through Fullenkamp, David A. via phone (260) 726-4210.

Contact Information

Primary practice address
1111 N Meridian St Portland IN 47371-1024
Phone: (260) 726-4210
Fax: (260) 726-9347
Website:
Map and Directions
Authorized official contact:
Name: Fullenkamp, David A. Doctor of Optometry (OD)
Phone: (260) 726-4210

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X 18002167A Indiana

Profile Details

NPI number 1235457862
LBN Legal business name David A. Fullenkamp,Od, Pc
DBA Doing business as
Authorized official Fullenkamp, David A. Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 6th, 2010
Last updated May 6th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235457862 NPPES
Indiana MEDICAID 100424160A
Indiana Other 0207200002

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