Provider Demographics
NPI:1669541108
Name:CAMPAGNA, KEITH DAVID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:DAVID
Last Name:CAMPAGNA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 BEECHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6949
Mailing Address - Country:US
Mailing Address - Phone:334-821-1483
Mailing Address - Fax:334-826-4053
Practice Address - Street 1:1 BEECHBROOK DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6949
Practice Address - Country:US
Practice Address - Phone:334-821-1483
Practice Address - Fax:334-826-4053
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL107441835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy