MEDICARE: DR. TRAVIS LYNN LAWSON PHARM.D.

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	0202205628	VA
2	183500000X	Pharmacist	012217	KY

General Provider Information

NPI Number	:	1386632453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRAVIS LYNN LAWSON PHARM.D.

Provider Business Mailing Address
First Line	:	PO BOX 220
Second Line	:
City	:	ROSE HILL
State	:	VA
Zip	:	24281-0220
Country	:	US
Telephone Number	:	276-445-5026
Fax Number	:	276-445-5029

Provider Business Practice Location Address
First Line	:	MAIN ST, OLD HWY 58
Second Line	:
City	:	ROSE HILL
State	:	VA
Zip	:	24281-0220
Country	:	US
Telephone Number	:	276-445-5026
Fax Number	:	276-445-5029

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	07/08/2007

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