Provider Demographics
NPI:1801600838
Name:CAMPBELL, MADISON VICTORIA (PHARMD)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:VICTORIA
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 1:318 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-1602
Mailing Address - Country:US
Mailing Address - Phone:606-253-7471
Mailing Address - Fax:
Practice Address - Street 1:100 MEADOW ST
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-3035
Practice Address - Country:US
Practice Address - Phone:276-236-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202222549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist