MEDICARE: LANCE CAMERON LEWIS 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	RPH-0012281	OR

General Provider Information

NPI Number	:	1992010102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANCE CAMERON LEWIS PHARM.D.

Provider Business Mailing Address
First Line	:	175 S COLUMBIA RIVER HWY
Second Line	:
City	:	SAINT HELENS
State	:	OR
Zip	:	97051-1647
Country	:	US
Telephone Number	:	503-397-7862
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 S COLUMBIA RIVER HWY
Second Line	:
City	:	SAINT HELENS
State	:	OR
Zip	:	97051-1647
Country	:	US
Telephone Number	:	503-397-7862
Fax Number	:

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

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	08/11/2010

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