Healthcare Provider Details

I. General information

NPI: 1972205193
Provider Name (Legal Business Name): CAMPTON PHARMACIST GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

797 KY 15 S
CAMPTON KY
41301-9553
US

IV. Provider business mailing address

125 FOXGLOVE DR STE A
MOUNT STERLING KY
40353-9735
US

V. Phone/Fax

Practice location:
  • Phone: 606-668-2273
  • Fax: 606-668-7699
Mailing address:
  • Phone: 606-668-2273
  • Fax: 606-668-7699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHERRY STEVENS
Title or Position: CRO
Credential: CPHT
Phone: 859-585-1854