MEDICARE: JAMES K LOHSE 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	P26541	FL

General Provider Information

NPI Number	:	1417226085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES K LOHSE PHARMD

Provider Business Mailing Address
First Line	:	1112 SW FOREST HILL CV
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2003
Country	:	US
Telephone Number	:	772-418-0421
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 SW FOREST HILL CV
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2003
Country	:	US
Telephone Number	:	772-418-0421
Fax Number	:

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

Provider Enumeration Date	:	12/27/2011
Last Update Date	:	12/27/2011

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