Provider Demographics
NPI:1669716205
Name:CAMPBELL UNIVERSITY INC
Entity type:Organization
Organization Name:CAMPBELL UNIVERSITY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FOR BUSINESS AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:O
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-893-1240
Mailing Address - Street 1:73 EAKES DRIVE
Mailing Address - Street 2:MCLEOD ATHLETIC TRAINING FACILIATY
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546
Mailing Address - Country:US
Mailing Address - Phone:910-814-5455
Mailing Address - Fax:910-893-1283
Practice Address - Street 1:5050 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-3995
Practice Address - Country:US
Practice Address - Phone:972-367-4820
Practice Address - Fax:972-367-3451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health