Provider Demographics
NPI:1083786305
Name:CAMP DRUGS, LLC
Entity Type:Organization
Organization Name:CAMP DRUGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-657-5187
Mailing Address - Street 1:18294 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HENAGAR
Mailing Address - State:AL
Mailing Address - Zip Code:35978-4374
Mailing Address - Country:US
Mailing Address - Phone:256-657-5187
Mailing Address - Fax:256-657-2232
Practice Address - Street 1:18294 BROAD ST
Practice Address - Street 2:
Practice Address - City:HENAGAR
Practice Address - State:AL
Practice Address - Zip Code:35978-4374
Practice Address - Country:US
Practice Address - Phone:256-657-5187
Practice Address - Fax:256-657-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003743Medicaid
FC0011899OtherDEA NUMBER
AL100003743Medicaid