MEDICARE: TRACEE LYNN CAMPBELL PHARMACIST

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	03443658	OH

General Provider Information

NPI Number	:	1902684996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEE LYNN CAMPBELL PHARMACIST

Provider Business Mailing Address
First Line	:	424 WARDS CORNER RD STE 200
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-6966
Country	:	US
Telephone Number	:	513-576-7700
Fax Number	:	513-576-1020

Provider Business Practice Location Address
First Line	:	2055 HOSPITAL DR STE 320
Second Line	:
City	:	BATAVIA
State	:	OH
Zip	:	45103-0165
Country	:	US
Telephone Number	:	513-732-0700
Fax Number	:	513-732-5084

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

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	09/20/2023

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