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NPI Code Detail

MEDICARE: CAMPUS PHARMACY

MEDICARE: CAMPUS PHARMACY
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
1183500000XPharmacist100-1023SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14303284OTHERSDNABP#
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124005269
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMPUS PHARMACY
Provider Business Mailing Address
First Line : 525 N FOSTER ST
Second Line :
City : MITCHELL
State : SD
Zip : 57301-2966
Country : US
Telephone Number : 605-995-5670
Fax Number : 605-996-6805
Provider Business Practice Location Address
First Line : 525 N FOSTER ST
Second Line :
City : MITCHELL
State : SD
Zip : 57301-2966
Country : US
Telephone Number : 605-995-5670
Fax Number : 605-996-6805
Authorized Official
Title or Position : CAMPUS PHARMACY MANAGER
Name : MRS. SHAWNA RAE HECK
Credential : R.PH.
Telephone Number : 605-995-5670
Provider Enumeration Date : 12/29/2005
Last Update Date : 03/07/2023

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Directions to “CAMPUS PHARMACY ” Practice Location

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