Healthcare Provider Details

I. General information

NPI: 1801124227
Provider Name (Legal Business Name): MONICA MARIE BOWEN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MONICA MARIE GEHRET PHARM.D.

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S LINCOLN AVE VA PHARMACY DEPARTMENT (719)
LEBANON PA
17042-7529
US

IV. Provider business mailing address

1700 S LINCOLN AVE VA PHARMACY DEPARTMENT (719)
LEBANON PA
17042-7529
US

V. Phone/Fax

Practice location:
  • Phone: 717-272-6621
  • Fax: 717-228-6163
Mailing address:
  • Phone: 717-272-6621
  • Fax: 717-228-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP443767
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP443767
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: