Provider Demographics
NPI:1215692397
Name:CAMP, WENDY R (RPH)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:R
Last Name:CAMP
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 MADELINE LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-7013
Mailing Address - Country:US
Mailing Address - Phone:959-867-6712
Mailing Address - Fax:
Practice Address - Street 1:762 MADELINE LN
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-7013
Practice Address - Country:US
Practice Address - Phone:334-740-9458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist