Provider Demographics
NPI:1447859582
Name:MCCAMISH, DEVIN LEVI (PHARMD)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:LEVI
Last Name:MCCAMISH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 DOLPHIN DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7135
Mailing Address - Country:US
Mailing Address - Phone:270-737-4578
Mailing Address - Fax:270-737-1932
Practice Address - Street 1:3040 DOLPHIN DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7135
Practice Address - Country:US
Practice Address - Phone:270-737-4578
Practice Address - Fax:270-737-1932
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist