Healthcare Provider Details

I. General information

NPI: 1093690406
Provider Name (Legal Business Name): KAMPULAND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 DERBY AVE
CINCINNATI OH
45232-1816
US

IV. Provider business mailing address

750 DERBY AVE
CINCINNATI OH
45232-1816
US

V. Phone/Fax

Practice location:
  • Phone: 513-873-8800
  • Fax:
Mailing address:
  • Phone: 513-873-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MR. DERRICK FRIERSON
Title or Position: OWNER
Credential:
Phone: 513-213-3679