MEDICARE: JOHN T KOZLOWSKI R.PH.

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	RP038315L	PA

General Provider Information

NPI Number	:	1659458982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN T KOZLOWSKI R.PH.

Provider Business Mailing Address
First Line	:	500 FOWLER AVE STE 202
Second Line	:
City	:	BERWICK
State	:	PA
Zip	:	18603-3326
Country	:	US
Telephone Number	:	570-520-4170
Fax Number	:	570-520-4179

Provider Business Practice Location Address
First Line	:	500 FOWLER AVE STE 202
Second Line	:
City	:	BERWICK
State	:	PA
Zip	:	18603-3326
Country	:	US
Telephone Number	:	570-520-4170
Fax Number	:	570-520-4179

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	01/07/2021

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