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General NPI Number Information
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NPI Number | 1093809964
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Entity Type | Organization
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Legal Business Name | CANDLER PHARMACY PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 745 S LEWIS ST
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City | METTER
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State | GA
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Zip | 30439-5128
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Country | US
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Telephone | 912-685-2000
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Fax | 912-685-2006
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Provider Business Mailing Address
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Address Line | 745 S LEWIS ST
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City | METTER
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State | GA
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Zip | 30439-5128
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Country | US
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Telephone | 912-685-2000
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Fax | 912-685-2006
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN ROBERT BOWEN JR.
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Credential | PHARMD
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Telephone | 912-685-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 20003127671
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License Number State | GA
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