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General NPI Number Information
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NPI Number | 1033206313
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Entity Type | Organization
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Legal Business Name | SANDRA CAMP INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1926 HIGHWAY 45 N
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City | COLUMBUS
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State | MS
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Zip | 39705-1949
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Country | US
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Telephone | 662-328-4038
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Fax | 662-328-4038
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Provider Business Mailing Address
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Address Line | 1926 HIGHWAY 45 N
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City | COLUMBUS
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State | MS
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Zip | 39705-1949
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Country | US
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Telephone | 662-328-4038
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Fax | 662-328-4038
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Authorized Official
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Title or Position | OWNER
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Name | MS. SANDRA CAROL CAMP
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Credential |
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Telephone | 662-328-4038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 044211860
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License Number State | MS
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