Provider Demographics
NPI:1851082218
Name:COWPENS COMMUNITY PHARMACY
Entity Type:Organization
Organization Name:COWPENS COMMUNITY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:MOUA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:864-504-7272
Mailing Address - Street 1:PO BOX 1149
Mailing Address - Street 2:
Mailing Address - City:COWPENS
Mailing Address - State:SC
Mailing Address - Zip Code:29330-1149
Mailing Address - Country:US
Mailing Address - Phone:864-406-0074
Mailing Address - Fax:
Practice Address - Street 1:5336 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:COWPENS
Practice Address - State:SC
Practice Address - Zip Code:29330
Practice Address - Country:US
Practice Address - Phone:864-406-0074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy