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General NPI Number Information
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NPI Number | 1053097246
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Entity Type | Individual
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Provider Name | AUSTIN CAMPBELL PHARMD, BCPP
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Gender | Male
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 101 S FAIRVIEW RD
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City | COLUMBIA
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State | MO
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Zip | 65203-7637
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Country | US
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Telephone | 573-882-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 5280 E RAITT RD
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City | HARTSBURG
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State | MO
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Zip | 65039-8000
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Country | US
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Telephone | 660-537-1589
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 2008028407
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License Number State | MO
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