Provider Demographics
NPI:1588851067
Name:CAMPBELLS COMPOUNDING PHARMACY INC
Entity Type:Organization
Organization Name:CAMPBELLS COMPOUNDING PHARMACY INC
Other - Org Name:CAMPBELLS COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:713-668-4833
Mailing Address - Street 1:4760 SWEETWATER BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3172
Mailing Address - Country:US
Mailing Address - Phone:281-980-2555
Mailing Address - Fax:281-980-2560
Practice Address - Street 1:4760 SWEETWATER BLVD
Practice Address - Street 2:STE 103
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3172
Practice Address - Country:US
Practice Address - Phone:281-980-2555
Practice Address - Fax:281-980-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336M0002X
TX256793336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4545882OtherNCPDP PROVIDER IDENTIFICATION NUMBER