Provider Demographics
NPI:1629537303
Name:CAMPFIELD, TRAISHA WHITE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRAISHA
Middle Name:WHITE
Last Name:CAMPFIELD
Suffix:
Gender:F
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-0749
Mailing Address - Country:US
Mailing Address - Phone:803-438-5735
Mailing Address - Fax:803-438-4657
Practice Address - Street 1:1107 ROSS ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045
Practice Address - Country:US
Practice Address - Phone:803-438-5735
Practice Address - Fax:803-438-4657
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist