Healthcare Provider Details

I. General information

NPI: 1265432181
Provider Name (Legal Business Name): ROBERT YOWLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HIGHWAY 42 E
BEDFORD KY
40006-7624
US

IV. Provider business mailing address

PO BOX 243
BEDFORD KY
40006-0243
US

V. Phone/Fax

Practice location:
  • Phone: 502-255-3540
  • Fax: 502-255-3615
Mailing address:
  • Phone: 502-255-3540
  • Fax: 502-255-3615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPO1566
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPO1566
License Number StateKY

VIII. Authorized Official

Name: MR. ROBERT PARKER YOWLER
Title or Position: REGISTERED PHARMACIST OWNER OF MORG
Credential: RPH
Phone: 502-255-3540