Provider Demographics
NPI:1760991137
Name:CAMPAGNA, ANN MONTGOMERY (RPH)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MONTGOMERY
Last Name:CAMPAGNA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BOULDEN CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3492
Mailing Address - Country:US
Mailing Address - Phone:302-395-8950
Mailing Address - Fax:
Practice Address - Street 1:2 BOULDEN CIR STE 1
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3492
Practice Address - Country:US
Practice Address - Phone:302-395-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist