MEDICARE: ALAN MCCAMPBELL 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	033.0003848	VT

General Provider Information

NPI Number	:	1043806789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN MCCAMPBELL RPH

Provider Business Mailing Address
First Line	:	1127 NORTH AVE STE 11
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05408-2756
Country	:	US
Telephone Number	:	802-862-7752
Fax Number	:

Provider Business Practice Location Address
First Line	:	1127 NORTH AVE STE 11
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05408-2756
Country	:	US
Telephone Number	:	802-862-7752
Fax Number	:

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

Provider Enumeration Date	:	12/16/2020
Last Update Date	:	12/16/2020

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