Provider Demographics
NPI:1174546543
Name:CAMPTON PHARMACARE INC
Entity type:Organization
Organization Name:CAMPTON PHARMACARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-585-4573
Mailing Address - Street 1:33 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CAMPTON
Mailing Address - State:KY
Mailing Address - Zip Code:41301-9750
Mailing Address - Country:US
Mailing Address - Phone:606-668-3153
Mailing Address - Fax:606-668-7203
Practice Address - Street 1:33 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CAMPTON
Practice Address - State:KY
Practice Address - Zip Code:41301-9750
Practice Address - Country:US
Practice Address - Phone:606-668-3153
Practice Address - Fax:606-668-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 332B00000X
KYP073763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122503OtherPK
KY7100121370Medicaid
KY7100091470Medicaid
6391760001Medicare NSC