Healthcare Provider Details

I. General information

NPI: 1932379369
Provider Name (Legal Business Name): DOWEL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 W 35TH ST STE 101
HIGGINSVILLE MO
64037-1872
US

IV. Provider business mailing address

810 W 35TH ST STE 101
HIGGINSVILLE MO
64037-1872
US

V. Phone/Fax

Practice location:
  • Phone: 660-584-2700
  • Fax: 660-584-3073
Mailing address:
  • Phone: 660-584-2700
  • Fax: 660-584-3073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2016027105
License Number StateMO

VIII. Authorized Official

Name: HEATHER MCGINNIS
Title or Position: CFO
Credential:
Phone: 660-584-7779