MEDICARE: MS. KIMBERLY LOWE 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
1	183500000X	Pharmacist	63696	CA

General Provider Information

NPI Number	:	1154656007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY LOWE PHARMD

Provider Business Mailing Address
First Line	:	7545 OSO BLANCA RD, APT# 3197
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	95148-1493
Country	:	US
Telephone Number	:	408-771-7105
Fax Number	:

Provider Business Practice Location Address
First Line	:	7545 OSO BLANCA RD, APT# 3197
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	95148-1493
Country	:	US
Telephone Number	:	408-771-7105
Fax Number	:

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

Provider Enumeration Date	:	10/09/2009
Last Update Date	:	05/05/2010

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