MEDICARE: CAMPBELLS COMPOUNDING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	22522	TX

General Provider Information

NPI Number	:	1023357878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMPBELLS COMPOUNDING

Provider Business Mailing Address
First Line	:	6603 KIRBY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-3900
Country	:	US
Telephone Number	:	713-668-4833
Fax Number	:	713-668-4812

Provider Business Practice Location Address
First Line	:	6603 KIRBY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-3900
Country	:	US
Telephone Number	:	713-668-4833
Fax Number	:	713-668-4812

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LANCE CAMPBELL
Credential	:
Telephone Number	:	713-668-4833

Provider Enumeration Date	:	02/13/2013
Last Update Date	:	02/13/2013

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Directions to “CAMPBELLS COMPOUNDING ” Practice Location

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