Provider Demographics
NPI:1417382623
Name:CAMP, LORI LAND (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:LAND
Last Name:CAMP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986-6014
Mailing Address - Country:US
Mailing Address - Phone:256-638-4232
Mailing Address - Fax:256-845-2076
Practice Address - Street 1:101 CRACKER BARREL ROW
Practice Address - Street 2:
Practice Address - City:FT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968
Practice Address - Country:US
Practice Address - Phone:256-845-1171
Practice Address - Fax:256-845-2076
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist