Provider Demographics
NPI:1952639551
Name:BOWEN PHARMACY INC
Entity Type:Organization
Organization Name:BOWEN PHARMACY INC
Other - Org Name:BOWEN PHARMACY SOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-421-4950
Mailing Address - Street 1:1519 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-3332
Mailing Address - Country:US
Mailing Address - Phone:620-421-4950
Mailing Address - Fax:620-421-4950
Practice Address - Street 1:1902 S HWY 59
Practice Address - Street 2:BLDG E SUITE 100
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4948
Practice Address - Country:US
Practice Address - Phone:620-421-1700
Practice Address - Fax:620-421-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS210275333600000X
3336C0003X, 3336C0004X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200002090EMedicaid
2122613OtherPK