Provider Demographics
NPI:1033239421
Name:CAMP, AMY MARIE (RP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:CAMP
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1024
Mailing Address - Country:US
Mailing Address - Phone:724-224-1844
Mailing Address - Fax:
Practice Address - Street 1:412 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084-1810
Practice Address - Country:US
Practice Address - Phone:724-224-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032895L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist