MEDICARE: ANGELA MARIE BOWEN

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	251E00000X	Home Health Agency	5719005	OH

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

General Provider Information

NPI Number	:	1477261568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MARIE BOWEN

Provider Business Mailing Address
First Line	:	515 CARLISLE AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45410-2734
Country	:	US
Telephone Number	:	937-654-7109
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 CARLISLE AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45410-2734
Country	:	US
Telephone Number	:	937-654-7109
Fax Number	:

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

Provider Enumeration Date	:	11/08/2022
Last Update Date	:	11/08/2022

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Directions to “ ANGELA MARIE BOWEN ” Practice Location

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