Provider Demographics
NPI:1093361867
Name:CAMERON MEDICAL OUTREACH, INC
Entity Type:Organization
Organization Name:CAMERON MEDICAL OUTREACH, INC
Other - Org Name:CAMERON RETAIL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-667-5645
Mailing Address - Street 1:306 E MAUMEE ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-2038
Mailing Address - Country:US
Mailing Address - Phone:260-667-5645
Mailing Address - Fax:260-667-5644
Practice Address - Street 1:306 E MAUMEE ST STE 106
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-2038
Practice Address - Country:US
Practice Address - Phone:260-667-5645
Practice Address - Fax:260-667-5644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy