Healthcare Provider Details

I. General information

NPI: 1295245470
Provider Name (Legal Business Name): KARA LOUGHLIN WILCOX PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 10/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 TELEGRAPH RD
MIDDLEPORT NY
14105-9638
US

IV. Provider business mailing address

304 WESTMINSTER RD
ROCHESTER NY
14607-3233
US

V. Phone/Fax

Practice location:
  • Phone: 716-735-3261
  • Fax:
Mailing address:
  • Phone: 585-770-3555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063466
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: