Provider Demographics
NPI:1548793599
Name:BOWEN, DWAIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DWAIN
Middle Name:
Last Name:BOWEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DEWEY
Other - Middle Name:
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8100 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2711
Mailing Address - Country:US
Mailing Address - Phone:303-248-7234
Mailing Address - Fax:
Practice Address - Street 1:8100 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2711
Practice Address - Country:US
Practice Address - Phone:303-248-7234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0021662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist