Provider Demographics
NPI:1710015649
Name:ROWSEY, ANGELA BAILEY
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:BAILEY
Last Name:ROWSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 COURT SQUARE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:MS
Mailing Address - Zip Code:38921-2232
Mailing Address - Country:US
Mailing Address - Phone:662-783-6100
Mailing Address - Fax:662-783-3007
Practice Address - Street 1:315 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:MS
Practice Address - Zip Code:38921-2232
Practice Address - Country:US
Practice Address - Phone:662-647-5541
Practice Address - Fax:662-647-5546
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-08803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist