Provider Demographics
NPI:1205833837
Name:BOWERS, DEBORAH DENISE (PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:DENISE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822B E LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-1661
Mailing Address - Country:US
Mailing Address - Phone:803-628-7934
Mailing Address - Fax:803-628-4194
Practice Address - Street 1:822B E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-1661
Practice Address - Country:US
Practice Address - Phone:803-628-7934
Practice Address - Fax:803-628-4194
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4558650001Medicare NSC
Y08257Medicare UPIN
Q33542001Medicare ID - Type Unspecified