MEDICARE: MARCIA D BOWENS

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	183700000X	Pharmacy Technician

General Provider Information

NPI Number	:	1467675595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA D BOWENS

Provider Business Mailing Address
First Line	:	500 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1613
Country	:	US
Telephone Number	:	215-685-6864
Fax Number	:	215-790-1651

Provider Business Practice Location Address
First Line	:	500 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1613
Country	:	US
Telephone Number	:	215-685-6864
Fax Number	:	215-790-1651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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