Provider Demographics
NPI:1093185258
Name:CAMPBELL, CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 SHEEP ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SNOW CAMP
Mailing Address - State:NC
Mailing Address - Zip Code:27349-9412
Mailing Address - Country:US
Mailing Address - Phone:919-663-6001
Mailing Address - Fax:919-663-6017
Practice Address - Street 1:14215 US HIGHWAY 64 W
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-6451
Practice Address - Country:US
Practice Address - Phone:919-663-6001
Practice Address - Fax:919-663-6017
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21724183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist