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NPI Code Detail

MEDICARE: SLATER KEITH LOMAX PHARMD

MEDICARE: SLATER KEITH LOMAX PHARMD
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
1183500000XPharmacistRPH032645GA
2183500000XPharmacist21728AL
3183500000XPharmacistT-100122MS
4183500000XPharmacist0000043341TN

General Provider Information

NPI Number : 1639842560
Entity Type Code : Individual
Provider Name (Legal Business Name) : SLATER KEITH LOMAX PHARMD
Provider Business Mailing Address
First Line : 1829 MAXWELL RD
Second Line :
City : DECATURVILLE
State : TN
Zip : 38329-4654
Country : US
Telephone Number : 731-549-7872
Fax Number :
Provider Business Practice Location Address
First Line : 1971 TENNESSEE AVE N
Second Line :
City : PARSONS
State : TN
Zip : 38363-5049
Country : US
Telephone Number : 731-847-4013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2021
Last Update Date : 07/27/2021

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Directions to “ SLATER KEITH LOMAX PHARMD” Practice Location

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