Provider Demographics
NPI:1134263296
Name:BOWIE'S PRIORITY CARE PHARMACY, LLC
Entity type:Organization
Organization Name:BOWIE'S PRIORITY CARE PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-980-1985
Mailing Address - Street 1:5100 CURRY HIGHWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35503
Mailing Address - Country:US
Mailing Address - Phone:205-221-4090
Mailing Address - Fax:205-295-1521
Practice Address - Street 1:5100 CURRY HIGHWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35503
Practice Address - Country:US
Practice Address - Phone:205-221-4090
Practice Address - Fax:205-295-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1016983336C0003X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100001496Medicaid