Provider Demographics
NPI:1194876094
Name:LOW COST RX INC
Entity type:Organization
Organization Name:LOW COST RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:SHINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-787-6912
Mailing Address - Street 1:4076 S KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-8621
Mailing Address - Country:US
Mailing Address - Phone:317-787-6912
Mailing Address - Fax:317-784-6380
Practice Address - Street 1:4076 S KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8621
Practice Address - Country:US
Practice Address - Phone:317-787-6912
Practice Address - Fax:317-784-6380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100292220Medicaid
IN0299760001Medicare NSC