Provider Demographics
NPI:1700923372
Name:LASLOW, ERNEST D (RPH)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:D
Last Name:LASLOW
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1703
Mailing Address - Country:US
Mailing Address - Phone:717-637-4003
Mailing Address - Fax:717-633-7460
Practice Address - Street 1:800 CARLISLE ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1703
Practice Address - Country:US
Practice Address - Phone:717-637-4003
Practice Address - Fax:717-633-7460
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032848R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA19106113601Medicaid
PA0736110001Medicare ID - Type UnspecifiedPROVIDER NUMBER