Provider Demographics
NPI:1942532247
Name:KOWAL, ANDREW HENRY (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:HENRY
Last Name:KOWAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:153 POMEROY MEADOW RD
Mailing Address - Street 2:R
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01073-9331
Mailing Address - Country:US
Mailing Address - Phone:413-527-3699
Mailing Address - Fax:800-565-8182
Practice Address - Street 1:153 POMEROY MEADOW RD
Practice Address - Street 2:R
Practice Address - City:SOUTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01073-9331
Practice Address - Country:US
Practice Address - Phone:413-527-3699
Practice Address - Fax:800-565-8182
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist