Provider Demographics
NPI:1588966253
Name:CAMPBELL, ROBERT T (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 RIVER POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:CO
Mailing Address - Zip Code:80110-3316
Mailing Address - Country:US
Mailing Address - Phone:303-200-1839
Mailing Address - Fax:303-200-1836
Practice Address - Street 1:4000 RIVER POINT PKWY
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:CO
Practice Address - Zip Code:80110-3316
Practice Address - Country:US
Practice Address - Phone:303-200-1839
Practice Address - Fax:303-200-1836
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist