MEDICARE: VICTORIA LOTZOW

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	26018564A	IN

General Provider Information

NPI Number	:	1881007326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA LOTZOW

Provider Business Mailing Address
First Line	:	6970 CORPORATE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1928
Country	:	US
Telephone Number	:	317-829-5470
Fax Number	:	888-881-8585

Provider Business Practice Location Address
First Line	:	6970 CORPORATE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1928
Country	:	US
Telephone Number	:	317-829-5470
Fax Number	:	888-881-8585

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

Provider Enumeration Date	:	06/03/2014
Last Update Date	:	06/03/2014

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Directions to “ VICTORIA LOTZOW ” Practice Location

Language	Start Address	Practice Location

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