MEDICARE: LOW COST RX 2 INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	60005206A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2026056	OTHER		PK

General Provider Information

NPI Number	:	1407867914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOW COST RX 2 INC

Provider Business Mailing Address
First Line	:	8375 MADISON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-6014
Country	:	US
Telephone Number	:	317-881-8262
Fax Number	:	317-881-9008

Provider Business Practice Location Address
First Line	:	8375 MADISON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-6014
Country	:	US
Telephone Number	:	317-881-8262
Fax Number	:	317-881-9008

Authorized Official
Title or Position	:	OWNER
Name	:	TERRY COLE
Credential	:
Telephone Number	:	317-881-8262

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	12/08/2014

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