MEDICARE: JOAN T. KAMPER RPH

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	183500000X	Pharmacist	RPH.03107795	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03107795	OTHER	OH	STATE BOARD OF PHARMACY

General Provider Information

NPI Number	:	1073758090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN T. KAMPER RPH

Provider Business Mailing Address
First Line	:	9225 LINDBERGH BLVD
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-2407
Country	:	US
Telephone Number	:	440-234-5659
Fax Number	:	440-234-6443

Provider Business Practice Location Address
First Line	:	9225 LINDBERGH BLVD
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-2407
Country	:	US
Telephone Number	:	440-234-5659
Fax Number	:	440-234-6443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2008
Last Update Date	:	12/04/2008

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