Provider Demographics
NPI:1316149701
Name:KINGDOM CONCEPTS, INC.
Entity type:Organization
Organization Name:KINGDOM CONCEPTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-875-2890
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71731-0680
Mailing Address - Country:US
Mailing Address - Phone:870-875-2890
Mailing Address - Fax:870-875-2892
Practice Address - Street 1:534 W FAULKNER ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4544
Practice Address - Country:US
Practice Address - Phone:870-875-2890
Practice Address - Fax:870-875-2892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty