MEDICARE: LESLIE LOWE RPH

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	RPH032546	GA

General Provider Information

NPI Number	:	1417548785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE LOWE RPH

Provider Business Mailing Address
First Line	:	50 COUCH ST
Second Line	:
City	:	SENOIA
State	:	GA
Zip	:	30276-1832
Country	:	US
Telephone Number	:	925-999-5767
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 HIGHWAY 74 S STE 20
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-3071
Country	:	US
Telephone Number	:	770-486-0133
Fax Number	:

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

Provider Enumeration Date	:	01/29/2021
Last Update Date	:	01/29/2021

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Directions to “ LESLIE LOWE RPH” Practice Location

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