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NPI Code Detail

MEDICARE: ANDREW CAMPBELL

MEDICARE:   ANDREW  CAMPBELL
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
1183500000XPharmacist26026145AIN

General Provider Information

NPI Number : 1871021246
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW CAMPBELL
Provider Business Mailing Address
First Line : 2803 E STATE BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4732
Country : US
Telephone Number : 260-483-3169
Fax Number :
Provider Business Practice Location Address
First Line : 2803 E STATE BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4732
Country : US
Telephone Number : 260-483-3169
Fax Number : 260-483-3160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2017
Last Update Date : 05/31/2017

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Directions to “ ANDREW CAMPBELL ” Practice Location

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