Healthcare Provider Details

I. General information

NPI: 1093123713
Provider Name (Legal Business Name): PATRICIA IRENE ROWE PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 N MAIZE RD
MAIZE KS
67101-9482
US

IV. Provider business mailing address

223 S PARKRIDGE CT
WICHITA KS
67209-4032
US

V. Phone/Fax

Practice location:
  • Phone: 316-722-2670
  • Fax:
Mailing address:
  • Phone: 620-217-1572
  • Fax: 316-722-2410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-10270
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: