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NPI Code Detail

MEDICARE: DR. SHANNON ASHLEY CAMPBELL PHARMD

MEDICARE: DR. SHANNON ASHLEY CAMPBELL PHARMD
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
1183500000XPharmacist10026SC

General Provider Information

NPI Number : 1528108255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON ASHLEY CAMPBELL PHARMD
Provider Business Mailing Address
First Line : 111 PINION LN
Second Line :
City : ANDERSON
State : SC
Zip : 29621-2572
Country : US
Telephone Number : 864-375-1831
Fax Number :
Provider Business Practice Location Address
First Line : 727 ANDERSON ST
Second Line :
City : BELTON
State : SC
Zip : 29627-2100
Country : US
Telephone Number : 864-338-8217
Fax Number : 864-338-6935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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