Healthcare Provider Details

I. General information

NPI: 1679400170
Provider Name (Legal Business Name): CAMPBELL MED LTC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 CAMPBELL AVE STE 1
WEST HAVEN CT
06516-3789
US

IV. Provider business mailing address

755 CAMPBELL AVE STE 1
WEST HAVEN CT
06516-3789
US

V. Phone/Fax

Practice location:
  • Phone: 203-937-1100
  • Fax: 203-937-1102
Mailing address:
  • Phone: 203-937-1100
  • Fax: 203-937-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ROXANN AMES
Title or Position: PRACTICE MANAGER
Credential:
Phone: 203-937-1100