Provider Demographics
NPI:1497974935
Name:BOWLING GREEN PHARMACY INC.
Entity Type:Organization
Organization Name:BOWLING GREEN PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-324-2080
Mailing Address - Street 1:8 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334-1534
Mailing Address - Country:US
Mailing Address - Phone:573-324-2080
Mailing Address - Fax:573-324-0048
Practice Address - Street 1:8 N COURT ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334-1534
Practice Address - Country:US
Practice Address - Phone:573-324-2080
Practice Address - Fax:573-324-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPS005349332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies