Provider Demographics
NPI:1134730773
Name:CAMPANELLA, PARKER DOUGLAS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PARKER
Middle Name:DOUGLAS
Last Name:CAMPANELLA
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 1:5006 BOONSBORO RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-1802
Mailing Address - Country:US
Mailing Address - Phone:434-386-6412
Mailing Address - Fax:
Practice Address - Street 1:5006 BOONSBORO RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-1802
Practice Address - Country:US
Practice Address - Phone:434-386-6412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022179991835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist