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General NPI Number Information
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NPI Number | 1144741372
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Entity Type | Individual
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Provider Name | PETER CAMPANELLA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 325 W S BOULDER RD STE 5
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City | LOUISVILLE
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State | CO
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Zip | 80027-1130
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Country | US
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Telephone | 720-458-4887
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Fax | 720-890-6144
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Provider Business Mailing Address
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Address Line | 11972 BLAKEFORD ST
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City | PARKER
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State | CO
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Zip | 80134-7762
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Country | US
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Telephone | 720-252-5749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA0017322
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License Number State | CO
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