MEDICARE: LOW PHARM 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	PP413912L	PA

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	2147704	OTHER		PK

General Provider Information

NPI Number	:	1821497611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOW PHARM INC.

Provider Business Mailing Address
First Line	:	20 BAILEY AVE
Second Line	:
City	:	MT WASHINGTON
State	:	PA
Zip	:	15211-1728
Country	:	US
Telephone Number	:	412-481-2400
Fax Number	:	412-481-9310

Provider Business Practice Location Address
First Line	:	20 BAILEY AVE
Second Line	:
City	:	MT WASHINGTON
State	:	PA
Zip	:	15211-1728
Country	:	US
Telephone Number	:	412-481-2400
Fax Number	:	412-481-9310

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JAMIE WYELS
Credential	:
Telephone Number	:	412-481-2400

Provider Enumeration Date	:	08/18/2014
Last Update Date	:	10/20/2016

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Directions to “LOW PHARM INC. ” Practice Location

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