=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255747192
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTINE LOWE PHARM. D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2014
-----------------------------------------------------
Last Update Date | 07/10/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4045 E BELL RD STE 163
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85032-2240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-971-6950
-----------------------------------------------------
Fax | 602-404-2504
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4045 E BELL RD STE 163
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85032-2240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-971-6950
-----------------------------------------------------
Fax | 602-404-2504
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | S015310
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------