MEDICARE: DR. JAMES BRIAN MOWRY PHARM.D.

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	1835P1200X	Pharmacotherapy Pharmacist	26016242A	IN

General Provider Information

NPI Number	:	1679502827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES BRIAN MOWRY PHARM.D.

Provider Business Mailing Address
First Line	:	604 N EAST ST
Second Line	:
City	:	LEBANON
State	:	IN
Zip	:	46052-1835
Country	:	US
Telephone Number	:	765-482-3217
Fax Number	:

Provider Business Practice Location Address
First Line	:	I-65 & 21ST STREET
Second Line	:	AG373
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-1367
Country	:	US
Telephone Number	:	317-962-2329
Fax Number	:

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	07/08/2007

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