MEDICARE: TIMOTHY LOBNER

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	18940	CO

General Provider Information

NPI Number	:	1164761557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY LOBNER

Provider Business Mailing Address
First Line	:	5401 CAMPGLEN DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-7632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 CAMPGLEN DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-7632
Country	:	US
Telephone Number	:	719-540-2734
Fax Number	:

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

Provider Enumeration Date	:	02/05/2013
Last Update Date	:	02/05/2013

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Directions to “ TIMOTHY LOBNER ” Practice Location

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