MEDICARE: DR. THOMAS MARK CAMPBELL PHARM.D.

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	183500000X	Pharmacist	32940	TN
2	183500000X	Pharmacist	17379	GA

General Provider Information

NPI Number	:	1437381308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS MARK CAMPBELL PHARM.D.

Provider Business Mailing Address
First Line	:	1 UNIVERSITY PARK DR
Second Line	:	LIPSCOMB UNIVERSITY COLLEGE OF PHARMACY
City	:	NASHVILLE
State	:	TN
Zip	:	37204-3956
Country	:	US
Telephone Number	:	615-966-7164
Fax Number	:	615-966-7163

Provider Business Practice Location Address
First Line	:	1 UNIVERSITY PARK DR
Second Line	:	LIPSCOMB UNIVERSITY COLLEGE OF PHARMACY
City	:	NASHVILLE
State	:	TN
Zip	:	37204-3956
Country	:	US
Telephone Number	:	615-966-7164
Fax Number	:	615-966-7163

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

Provider Enumeration Date	:	08/11/2009
Last Update Date	:	08/11/2009

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