Provider Demographics
NPI:1619013513
Name:ROWE, LORI WISE (RPH)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:WISE
Last Name:ROWE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26924 NW 84TH PL
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-8656
Mailing Address - Country:US
Mailing Address - Phone:386-454-0551
Mailing Address - Fax:
Practice Address - Street 1:619 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4428
Practice Address - Country:US
Practice Address - Phone:352-732-3666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0030585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist