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NPI Code Detail

MEDICARE: BRUCE LESLIE CAMPBELL RPH

MEDICARE: BRUCE LESLIE CAMPBELL 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
1183500000XPharmacist26012631AIN

General Provider Information

NPI Number : 1265045215
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE LESLIE CAMPBELL RPH
Provider Business Mailing Address
First Line : 455 E EPLER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-1902
Country : US
Telephone Number : 317-788-6671
Fax Number : 317-788-6716
Provider Business Practice Location Address
First Line : 455 E EPLER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-1902
Country : US
Telephone Number : 317-788-6671
Fax Number : 317-788-6716
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 08/28/2020

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Directions to “ BRUCE LESLIE CAMPBELL RPH” Practice Location

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