Provider Demographics
NPI:1083714539
Name:BOWSER, THOMAS EVAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EVAN
Last Name:BOWSER
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 1:241 W LONG AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2105
Mailing Address - Country:US
Mailing Address - Phone:814-541-4306
Mailing Address - Fax:814-371-4556
Practice Address - Street 1:241 W LONG AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2105
Practice Address - Country:US
Practice Address - Phone:814-371-9320
Practice Address - Fax:814-371-4556
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031095L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist