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General NPI Number Information
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NPI Number | 1891163135
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Entity Type | Individual
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Provider Name | WALTER ROBERT LORENZ III PHARM D
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Gender | Male
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 4957 CARLISLE PIKE
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City | MECHANICSBURG
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State | PA
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Zip | 17055
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Country | US
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Telephone | 717-975-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 5074 PAJABON DR APT 304
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City | HARRISBURG
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State | PA
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Zip | 17111-5906
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Country | US
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Telephone | 724-816-4644
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP449492
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License Number State | PA
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