Provider Demographics
NPI:1093052250
Name:COWAN, MICHAEL WAISTELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WAISTELL
Last Name:COWAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RAPUANO WAY
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7506
Mailing Address - Country:US
Mailing Address - Phone:717-254-9402
Mailing Address - Fax:
Practice Address - Street 1:320 YORK RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3180
Practice Address - Country:US
Practice Address - Phone:717-245-0116
Practice Address - Fax:717-243-6243
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2019-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist