Provider Demographics
NPI:1730232893
Name:CAMPTON PHARMACARE, INC.
Entity type:Organization
Organization Name:CAMPTON PHARMACARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-668-3153
Mailing Address - Street 1:PO BOX 1359
Mailing Address - Street 2:
Mailing Address - City:CAMPTON
Mailing Address - State:KY
Mailing Address - Zip Code:41301-1359
Mailing Address - Country:US
Mailing Address - Phone:606-668-3153
Mailing Address - Fax:606-668-7203
Practice Address - Street 1:33 MAIN ST.
Practice Address - Street 2:SUITE 2
Practice Address - City:CAMPTON
Practice Address - State:KY
Practice Address - Zip Code:41301
Practice Address - Country:US
Practice Address - Phone:606-668-3153
Practice Address - Fax:606-668-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90021197Medicaid
1816113OtherNCPDP
6391760001Medicare NSC