Provider Demographics
NPI:1114136413
Name:CAMPS, DILMARIE (PHAS)
Entity Type:Individual
Prefix:
First Name:DILMARIE
Middle Name:
Last Name:CAMPS
Suffix:
Gender:F
Credentials:PHAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-0417
Mailing Address - Country:US
Mailing Address - Phone:787-716-4493
Mailing Address - Fax:
Practice Address - Street 1:5 CALLE ALMODOVAR
Practice Address - Street 2:FARMACIA LA INMACULADA
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-3302
Practice Address - Country:US
Practice Address - Phone:787-734-4399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2225183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician