NPIMap

Organization Active NPI

Cameron Medical Outreach, Inc

Doing business as Cameron Retail Pharmacy

  • Community/Retail Pharmacy
  • Angola, IN
National Provider Identifier
1093361867
Registry record updated Jul 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CAMERON MEDICAL OUTREACH, INC
Doing business as
Cameron Retail Pharmacy
Practice address
306 E Maumee St Ste 106
Angola, IN 46703-2038
Phone
(260) 667-5645
Fax
(260) 667-5644
NPI assigned
Aug 16, 2019
Last updated
Jul 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hannah Denney
Title
Director of Outpatient Pharmacy
Phone
(260) 667-5645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

306 E Maumee St Ste 106
Angola, IN 46703-2038

Mailing address

306 E Maumee St Ste 106
Angola, IN 46703-2038
Phone (260) 667-5645

Other names 1

  • Cameron Retail Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200807000552 IN Part B Supplier - Mass Immunization (Roster Biller Only) 9537584826 Practice locations: Angola, IN

National Provider Directory

National Provider Directory
Tax ID family
Cameron Memorial Community Hospital Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

306 E Maumee St
Ste 106
Angola, IN 46703
Phone (260) 667-5645

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658016000000",
    "number": "1093361867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST STE 106",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032038",
            "telephone_number": "260-667-5645",
            "fax_number": "260-667-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST STE 106",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032038",
            "telephone_number": "260-667-5645",
            "fax_number": "260-667-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMERON MEDICAL OUTREACH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-16",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A",
        "authorized_official_last_name": "DENNEY",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT PHARMACY",
        "authorized_official_telephone_number": "260-667-5645"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cameron Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cameron Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Angola, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.