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General NPI Number Information
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NPI Number | 1225376544
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Entity Type | Organization
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Legal Business Name | J & M BOWLES LLC
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Dates
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Enumeration Date | 01/21/2013
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 2200 W 15TH ST
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City | EDMOND
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-330-1089
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Fax | 405-330-1092
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Provider Business Mailing Address
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Address Line | 820 WEST DANFORTH ROAD #A4
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City | EDMOND
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State | OK
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Zip | 73003
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Country | US
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Telephone | 405-330-1089
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Fax | 405-330-1092
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. JEREMY MICHAEL BOWLES
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Credential | DPH
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Telephone | 405-330-1089
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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 | 1-6149
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 7-8058
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License Number State | OK
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