Healthcare Provider Details

I. General information

NPI: 1720605488
Provider Name (Legal Business Name): TAYLOR BOWEN HARMAN PHARMD, RPH, AAHIVP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 AIRTECH PKWY
PLAINFIELD IN
46168-7455
US

IV. Provider business mailing address

328 N TACOMA AVE
INDIANAPOLIS IN
46201-3242
US

V. Phone/Fax

Practice location:
  • Phone: 317-963-7100
  • Fax:
Mailing address:
  • Phone: 215-280-2328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number023741
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17976
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03443558
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number126174
License Number StateMN
# 5
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26028768A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: