Provider Demographics
NPI:1912298464
Name:LOW, HENRY (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:LOW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 N ST
Mailing Address - Street 2:
Mailing Address - City:NEWMAN
Mailing Address - State:CA
Mailing Address - Zip Code:95360-1419
Mailing Address - Country:US
Mailing Address - Phone:209-862-1208
Mailing Address - Fax:
Practice Address - Street 1:1935 N ST
Practice Address - Street 2:
Practice Address - City:NEWMAN
Practice Address - State:CA
Practice Address - Zip Code:95360-1419
Practice Address - Country:US
Practice Address - Phone:209-862-1208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist