Provider Demographics
NPI:1063576346
Name:ARKANSAS EYEWEAR, INC.
Entity type:Organization
Organization Name:ARKANSAS EYEWEAR, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROZAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-664-5354
Mailing Address - Street 1:5300 W. MARKHAM
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3528
Mailing Address - Country:US
Mailing Address - Phone:501-664-5354
Mailing Address - Fax:501-664-5257
Practice Address - Street 1:5300 W. MARKHAM
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3528
Practice Address - Country:US
Practice Address - Phone:501-664-5354
Practice Address - Fax:501-664-5257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0394250001Medicare NSC