Provider Demographics
NPI:1528108255
Name:CAMPBELL, SHANNON ASHLEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:ASHLEY
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PINION LN
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2572
Mailing Address - Country:US
Mailing Address - Phone:864-375-1831
Mailing Address - Fax:
Practice Address - Street 1:727 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-2100
Practice Address - Country:US
Practice Address - Phone:864-338-8217
Practice Address - Fax:864-338-6935
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist