Provider Demographics
NPI:1407867914
Name:LOW COST RX 2 INC
Entity Type:Organization
Organization Name:LOW COST RX 2 INC
Other - Org Name:LOW COST RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-881-8262
Mailing Address - Street 1:8375 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-6014
Mailing Address - Country:US
Mailing Address - Phone:317-881-8262
Mailing Address - Fax:317-881-9008
Practice Address - Street 1:8375 MADISON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-6014
Practice Address - Country:US
Practice Address - Phone:317-881-8262
Practice Address - Fax:317-881-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IN60005206A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200201160Medicaid
2026056OtherPK
IN200201160Medicaid