Provider Demographics
NPI:1073113858
Name:ALUMBAUGH, CAMILLE DENISE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:DENISE
Last Name:ALUMBAUGH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12212 WEDD ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1669
Mailing Address - Country:US
Mailing Address - Phone:620-694-6563
Mailing Address - Fax:
Practice Address - Street 1:6860 W 115TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-2457
Practice Address - Country:US
Practice Address - Phone:620-694-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist