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General NPI Number Information
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NPI Number | 1679200349
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Entity Type | Individual
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Provider Name | TIMOTHY PAUL BOWDEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 450 S 900 E STE 150
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-2959
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Country | US
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Telephone | 801-433-9500
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Fax | 801-679-4748
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Provider Business Mailing Address
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Address Line | 4029 LILY DR
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City | ROY
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State | UT
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Zip | 84067-9609
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Country | US
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Telephone | 801-698-3911
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 5739117-1701
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License Number State | UT
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