MEDICARE: ROBERT YOWLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PO1566	KY
2	332B00000X	Durable Medical Equipment & Medical Supplies	PO1566	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	FLU 0266	OTHER	KY	FLU
3	1816048	OTHER	KY	NABP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	PO1566	OTHER	KY	PHARMACY

General Provider Information

NPI Number	:	1265432181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT YOWLER

Provider Business Mailing Address
First Line	:	PO BOX 243
Second Line	:
City	:	BEDFORD
State	:	KY
Zip	:	40006-0243
Country	:	US
Telephone Number	:	502-255-3540
Fax Number	:	502-255-3615

Provider Business Practice Location Address
First Line	:	325 HIGHWAY 42 E
Second Line	:
City	:	BEDFORD
State	:	KY
Zip	:	40006-7624
Country	:	US
Telephone Number	:	502-255-3540
Fax Number	:	502-255-3615

Authorized Official
Title or Position	:	REGISTERED PHARMACIST OWNER OF MORG
Name	:	MR. ROBERT PARKER YOWLER
Credential	:	RPH
Telephone Number	:	502-255-3540

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	03/07/2023

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