Provider Demographics
NPI:1982742359
Name:BOWLER, MICHAEL W (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:W
Last Name:BOWLER
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 1:101 STEPHENS ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01022-1056
Mailing Address - Country:US
Mailing Address - Phone:413-593-1220
Mailing Address - Fax:
Practice Address - Street 1:459 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1691
Practice Address - Country:US
Practice Address - Phone:413-596-9915
Practice Address - Fax:413-596-6579
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist