Provider Demographics
NPI:1457645558
Name:PITTS, CAMILE JOY (RPH)
Entity Type:Individual
Prefix:
First Name:CAMILE
Middle Name:JOY
Last Name:PITTS
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 1:900 NICOLLET MALL
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2530
Mailing Address - Country:US
Mailing Address - Phone:612-338-5215
Mailing Address - Fax:
Practice Address - Street 1:900 NICOLLET MALL
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2530
Practice Address - Country:US
Practice Address - Phone:612-338-5215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist