Provider Demographics
NPI:1356529523
Name:BOWERS, PAMELA MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARIE
Last Name:BOWERS
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 1:17 JOYOUS LN
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-4034
Mailing Address - Country:US
Mailing Address - Phone:518-384-7201
Mailing Address - Fax:518-207-9000
Practice Address - Street 1:465 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:COLONIE
Practice Address - State:NY
Practice Address - Zip Code:12205-2516
Practice Address - Country:US
Practice Address - Phone:518-482-2835
Practice Address - Fax:518-482-3847
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039458-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist