MEDICARE: RONALD JOHN CAMPBELL JR. PHRAM.D.

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	1835P1200X	Pharmacotherapy Pharmacist	RP046179L	PA

General Provider Information

NPI Number	:	1770574899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD JOHN CAMPBELL JR. PHRAM.D.

Provider Business Mailing Address
First Line	:	2918 KINGSTON CT
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-9633
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 FREEPORT RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15215-3301
Country	:	US
Telephone Number	:	412-784-4956
Fax Number	:

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	07/08/2007

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