Provider Demographics
NPI:1336483577
Name:MOWRY, JOHN STEWART (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STEWART
Last Name:MOWRY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-2746
Mailing Address - Country:US
Mailing Address - Phone:831-373-1225
Mailing Address - Fax:
Practice Address - Street 1:133 15TH ST
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2746
Practice Address - Country:US
Practice Address - Phone:831-373-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-10
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist