Provider Demographics
NPI:1255314878
Name:CAMPBELL, DUSTIN PAUL (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:PAUL
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 ECKMANSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697-9719
Mailing Address - Country:US
Mailing Address - Phone:937-695-0984
Mailing Address - Fax:
Practice Address - Street 1:35 E 2ND ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45144-1301
Practice Address - Country:US
Practice Address - Phone:937-549-3773
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-26719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist