Provider Demographics
NPI:1619286614
Name:BOWEN, BRANDY (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 ASHLEY 470 N
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646-9748
Mailing Address - Country:US
Mailing Address - Phone:870-415-1372
Mailing Address - Fax:870-415-1372
Practice Address - Street 1:302 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:AR
Practice Address - Zip Code:71646-3230
Practice Address - Country:US
Practice Address - Phone:870-853-2191
Practice Address - Fax:870-853-2199
Is Sole Proprietor?:No
Enumeration Date:2010-09-25
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP10931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist