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General NPI Number Information
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NPI Number | 1124005269
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Entity Type | Organization
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Legal Business Name | CAMPUS PHARMACY
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 525 N FOSTER ST
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City | MITCHELL
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State | SD
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Zip | 57301-2966
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Country | US
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Telephone | 605-995-5670
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Fax | 605-996-6805
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Provider Business Mailing Address
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Address Line | 525 N FOSTER ST
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City | MITCHELL
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State | SD
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Zip | 57301-2966
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Country | US
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Telephone | 605-995-5670
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Fax | 605-996-6805
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Authorized Official
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Title or Position | CAMPUS PHARMACY MANAGER
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Name | MRS. SHAWNA RAE HECK
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Credential | R.PH.
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Telephone | 605-995-5670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 100-1023
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License Number State | SD
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