Active NPI
Raymond Glen Campbell
- Pharmacist
- Fairmont, WV
National Provider Identifier
1548861206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0005216
- Practice address
- 32 Tygart Mall Loop
Fairmont, WV 26554-2187 - Phone
- (304) 366-9117
- Fax
- (304) 366-1583
- NPI assigned
- Nov 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0005216 | WV | Primary |
Addresses
Primary practice location
32 Tygart Mall Loop
Fairmont, WV 26554-2187
Mailing address
17 Troy LN
Fairmont, WV 26554-1463
Phone (304) 816-2036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP0005216 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604707200000",
"number": "1548861206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 TROY LN",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265541463",
"telephone_number": "304-816-2036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 TYGART MALL LOOP",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265542187",
"telephone_number": "304-366-9117",
"fax_number": "304-366-1583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "RAYMOND",
"middle_name": "GLEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-07",
"last_updated": "2020-11-07",
"certification_date": "2020-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0005216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairmont, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.