Provider Demographics
NPI:1083737076
Name:IRBY, LOWELL KIRK (RPH, PHC)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:KIRK
Last Name:IRBY
Suffix:
Gender:M
Credentials:RPH, PHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 N 13TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1167
Mailing Address - Country:US
Mailing Address - Phone:505-746-6681
Mailing Address - Fax:505-746-6647
Practice Address - Street 1:612 N 13TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1167
Practice Address - Country:US
Practice Address - Phone:505-746-6681
Practice Address - Fax:505-746-6647
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist