Provider Demographics
NPI:1821497611
Name:LOW PHARM INC.
Entity Type:Organization
Organization Name:LOW PHARM INC.
Other - Org Name:THE MEDICINE SHOPPE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WYELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-481-2400
Mailing Address - Street 1:20 BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1728
Mailing Address - Country:US
Mailing Address - Phone:412-481-2400
Mailing Address - Fax:412-481-9310
Practice Address - Street 1:20 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15211-1728
Practice Address - Country:US
Practice Address - Phone:412-481-2400
Practice Address - Fax:412-481-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-18
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP413912L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029833630001Medicaid
2147704OtherPK
PA1029833630001Medicaid