Provider Demographics
NPI:1679469233
Name:BOWEN, ADALINE C (CPHT)
Entity type:Individual
Prefix:
First Name:ADALINE
Middle Name:C
Last Name:BOWEN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7379 WASHINGTON BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6358
Mailing Address - Country:US
Mailing Address - Phone:202-779-0705
Mailing Address - Fax:
Practice Address - Street 1:7379 WASHINGTON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6358
Practice Address - Country:US
Practice Address - Phone:202-779-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
T9Q2H3W2183700000X
MDT20448183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician