Healthcare Provider Details

I. General information

NPI: 1023731163
Provider Name (Legal Business Name): CAMERON DEYELL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 KAPPA DR
PITTSBURGH PA
15238-2809
US

IV. Provider business mailing address

101 KAPPA DR
PITTSBURGH PA
15238-2809
US

V. Phone/Fax

Practice location:
  • Phone: 724-518-5463
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP457129
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: