Healthcare Provider Details

I. General information

NPI: 1750615936
Provider Name (Legal Business Name): BOWEN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 MAIN ST
PARSONS KS
67357-3332
US

IV. Provider business mailing address

1519 MAIN ST
PARSONS KS
67357-3332
US

V. Phone/Fax

Practice location:
  • Phone: 620-421-4950
  • Fax: 620-421-9252
Mailing address:
  • Phone: 620-421-4950
  • Fax: 620-421-9252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number210262
License Number StateKS

VII. Legacy identifiers

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

# 1
Identifier30003950950003
Identifier TypeMEDICAID
Identifier StateKS
Identifier Issuer

VIII. Authorized Official

Name: DR. BRIAN SCOTT WEST
Title or Position: OWNER/PRES
Credential: PHARM D
Phone: 620-421-4950