Provider Demographics
NPI:1497474282
Name:LOWERY, NATHAN SCOTT (PHARM D)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:SCOTT
Last Name:LOWERY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S ANN ST
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEGANY
Mailing Address - State:PA
Mailing Address - Zip Code:16743-1425
Mailing Address - Country:US
Mailing Address - Phone:814-558-1887
Mailing Address - Fax:814-225-4724
Practice Address - Street 1:170 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELDRED
Practice Address - State:PA
Practice Address - Zip Code:16731-4522
Practice Address - Country:US
Practice Address - Phone:814-225-4723
Practice Address - Fax:814-225-4724
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI015878183500000X
PARP457070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI015878OtherSTATE BOARD OF PHARMACY
PARP457070OtherSTATE BOARD OF PHARMACY