Provider Demographics
NPI:1477900702
Name:DELCAMPO, GEORGE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:DELCAMPO
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 1:46 OLD MEADOW PLAIN RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2733
Mailing Address - Country:US
Mailing Address - Phone:860-392-9548
Mailing Address - Fax:
Practice Address - Street 1:121 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4217
Practice Address - Country:US
Practice Address - Phone:860-582-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist