| Organization Name: | CAMPBELL MEDICAL SERVICES, LLC |
| NPI Number: | 1023263589 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHANNA D. PERERA (OWNER) |
| Mailing Address: | 755 Campbell Ave Suite 3 West Haven |
| State: | CT US |
| Postal Code: | 065163715 |
| Phone Number: | 2039371100 |
| Fax Number: | 2039371102 |
| NPI Enumeration Date: | 11/25/2008 |
| NPI Last Update Date: | 11/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 002961 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |