Provider Demographics
NPI:1891787487
Name:BOWERS, AMANDA C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:C
Last Name:BOWERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 LAKE VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:PINEY FLATS
Mailing Address - State:TN
Mailing Address - Zip Code:37686-3358
Mailing Address - Country:US
Mailing Address - Phone:423-538-0861
Mailing Address - Fax:
Practice Address - Street 1:1921 HIGHWAY 394
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-5454
Practice Address - Country:US
Practice Address - Phone:423-323-3312
Practice Address - Fax:423-323-1836
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000012079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist