Provider Demographics
NPI:1407269574
Name:MOWERY, ANGELINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:MOWERY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8245 W THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-4722
Mailing Address - Country:US
Mailing Address - Phone:623-849-1940
Mailing Address - Fax:623-849-2405
Practice Address - Street 1:8245 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-4722
Practice Address - Country:US
Practice Address - Phone:623-849-1940
Practice Address - Fax:623-849-2405
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist