Provider Demographics
NPI:1396861472
Name:CAMPBELL, ELAINE E (RPH)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:E
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RPH
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 63
Mailing Address - Street 2:
Mailing Address - City:BRANDAMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19316-0063
Mailing Address - Country:US
Mailing Address - Phone:610-384-0651
Mailing Address - Fax:
Practice Address - Street 1:1169 HORSESHOE PIKE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1367
Practice Address - Country:US
Practice Address - Phone:610-269-7368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031684L1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy