Provider Demographics
NPI:1689911364
Name:CAMPBELL, ARIEL M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:M
Last Name:CAMPBELL
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 1:2235 GLENWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2307
Mailing Address - Country:US
Mailing Address - Phone:404-373-3531
Mailing Address - Fax:404-373-9806
Practice Address - Street 1:2235 GLENWOOD AVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-2307
Practice Address - Country:US
Practice Address - Phone:404-373-3531
Practice Address - Fax:404-373-9806
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA026869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist