Provider Demographics
NPI:1114965209
Name:CAMPBELL MEDICAL
Entity Type:Organization
Organization Name:CAMPBELL MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:256-547-8981
Mailing Address - Street 1:634 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-3722
Mailing Address - Country:US
Mailing Address - Phone:256-547-8981
Mailing Address - Fax:
Practice Address - Street 1:634 BROAD ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-3722
Practice Address - Country:US
Practice Address - Phone:256-547-8981
Practice Address - Fax:256-547-8982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5722340001Medicare NSC