Provider Demographics
NPI:1356939243
Name:BOWSHER, SCOTT DANIEL (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:DANIEL
Last Name:BOWSHER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8106 E CEDAR CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47872-7728
Mailing Address - Country:US
Mailing Address - Phone:812-239-7536
Mailing Address - Fax:
Practice Address - Street 1:1238 S 3RD ST STE C
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-1006
Practice Address - Country:US
Practice Address - Phone:812-234-8305
Practice Address - Fax:812-234-0225
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018220A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist