Provider Demographics
NPI:1821683509
Name:BOWEN, CYNTHIA LITTLE (RPH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LITTLE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 SOUTH ADAMS ST
Mailing Address - Street 2:FAMILY PHARMACY OF FULTON
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843
Mailing Address - Country:US
Mailing Address - Phone:662-862-7979
Mailing Address - Fax:662-862-7843
Practice Address - Street 1:1313 SOUTH ADAMS ST
Practice Address - Street 2:FAMILY PHARMACY OF FULTON
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843-3884
Practice Address - Country:US
Practice Address - Phone:662-862-7979
Practice Address - Fax:662-862-7843
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE07619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist