Provider Demographics
NPI:1528482494
Name:TOW, PAUL ALLEN (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ALLEN
Last Name:TOW
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 1:1103 WOODLAND TRCE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:IN
Mailing Address - Zip Code:47143-9482
Mailing Address - Country:US
Mailing Address - Phone:812-294-3510
Mailing Address - Fax:812-218-6665
Practice Address - Street 1:2750 ALLISON LN
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-5952
Practice Address - Country:US
Practice Address - Phone:812-218-6610
Practice Address - Fax:812-218-6665
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014628A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist