Provider Demographics
NPI:1083099352
Name:FOWLER, ROBERT ROGERS III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ROGERS
Last Name:FOWLER
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1195 REMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-3528
Mailing Address - Country:US
Mailing Address - Phone:843-744-8896
Mailing Address - Fax:
Practice Address - Street 1:1195 REMOUNT RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-3528
Practice Address - Country:US
Practice Address - Phone:843-744-8896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist