Provider Demographics
NPI:1558094219
Name:CAMPBELL, VINCENT (PHARMD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
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 1:6400 S FIDDLERS GREEN CIRCLE
Mailing Address - Street 2:SUITE 250 #1003
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-226-1122
Mailing Address - Fax:
Practice Address - Street 1:450 KEN PRATT BLVD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-8522
Practice Address - Country:US
Practice Address - Phone:303-532-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0024015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist