Provider Demographics
NPI:1093123713
Name:ROWE, PATRICIA IRENE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:IRENE
Last Name:ROWE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 S PARKRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-4032
Mailing Address - Country:US
Mailing Address - Phone:620-217-1572
Mailing Address - Fax:316-722-2410
Practice Address - Street 1:5340 N MAIZE RD
Practice Address - Street 2:
Practice Address - City:MAIZE
Practice Address - State:KS
Practice Address - Zip Code:67101-9482
Practice Address - Country:US
Practice Address - Phone:316-722-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-10270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-10270Other18 PHARMACY SERVICE PROVIDERS