Provider Demographics
NPI:1043604564
Name:BOWLING GREEN & ASSOC, LLC
Entity Type:Organization
Organization Name:BOWLING GREEN & ASSOC, LLC
Other - Org Name:BG PHARMACY & MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-551-8572
Mailing Address - Street 1:20 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DANIA
Mailing Address - State:FL
Mailing Address - Zip Code:33004-3605
Mailing Address - Country:US
Mailing Address - Phone:954-551-8572
Mailing Address - Fax:
Practice Address - Street 1:20 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DANIA
Practice Address - State:FL
Practice Address - Zip Code:33004-3605
Practice Address - Country:US
Practice Address - Phone:954-551-8572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH289713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH28971OtherSTATE LICENSE