Provider Demographics
NPI:1386975688
Name:CAMPOS, GEORGE RUBEN (PHARM D)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:RUBEN
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7115 E TANQUE VERDE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3431
Mailing Address - Country:US
Mailing Address - Phone:520-886-8257
Mailing Address - Fax:520-296-4592
Practice Address - Street 1:7115 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3431
Practice Address - Country:US
Practice Address - Phone:520-886-8257
Practice Address - Fax:520-296-4592
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS011236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist