Provider Demographics
NPI:1316215239
Name:BOWDRE, SHARON D (RPH)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:BOWDRE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6564 HEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38141-0715
Mailing Address - Country:US
Mailing Address - Phone:901-488-9454
Mailing Address - Fax:
Practice Address - Street 1:6980 E HOLMES RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38141-8506
Practice Address - Country:US
Practice Address - Phone:901-309-5766
Practice Address - Fax:901-309-6718
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist