Provider Demographics
NPI:1093973406
Name:BOWEN, JOHN ROBERT JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:BOWEN
Suffix:JR
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 1:745 S LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439-5128
Mailing Address - Country:US
Mailing Address - Phone:912-685-2000
Mailing Address - Fax:912-685-2006
Practice Address - Street 1:745 S LEWIS ST
Practice Address - Street 2:
Practice Address - City:METTER
Practice Address - State:GA
Practice Address - Zip Code:30439
Practice Address - Country:US
Practice Address - Phone:912-685-2000
Practice Address - Fax:912-685-2006
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH018587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist