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General NPI Number Information
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NPI Number | 1942396619
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Entity Type | Individual
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Provider Name | RICHARD E COWAN R.PH.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2295 PARKLAKE DR NE BUILDING 12, SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30345-2801
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Country | US
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Telephone | 770-986-4773
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Fax |
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Provider Business Mailing Address
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Address Line | 511 AUTUMN OAKS DR
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City | ELLISVILLE
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State | MO
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Zip | 63021-5990
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Country | US
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Telephone | 636-256-2974
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-09136
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 028397
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License Number State | MO
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