Healthcare Provider Details

I. General information

NPI: 1053602532
Provider Name (Legal Business Name): CAMCADE IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HILL ST
WARREN AR
71671-2483
US

IV. Provider business mailing address

200 HILL ST
WARREN AR
71671-2483
US

V. Phone/Fax

Practice location:
  • Phone: 870-226-6140
  • Fax:
Mailing address:
  • Phone: 870-226-6140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: JANZY COBB
Title or Position: PRESIDENT
Credential:
Phone: 870-226-6140