Healthcare Provider Details

I. General information

NPI: 1023323631
Provider Name (Legal Business Name): KRISTINA BOWSER PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SNYDER AVE
PHILADELPHIA PA
19148-2700
US

IV. Provider business mailing address

123 WHARTON ST
PHILADELPHIA PA
19147-5426
US

V. Phone/Fax

Practice location:
  • Phone: 215-465-3270
  • Fax:
Mailing address:
  • Phone: 609-519-1376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03370000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP445148
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: