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NPI Code Detail

MEDICARE: HERBERT BRUCE BOWMAN RPH

MEDICARE: HERBERT BRUCE BOWMAN RPH
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
1183500000XPharmacist004140NM

General Provider Information

NPI Number : 1700208675
Entity Type Code : Individual
Provider Name (Legal Business Name) : HERBERT BRUCE BOWMAN RPH
Provider Business Mailing Address
First Line : 3621 MARY ELLEN ST NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-4803
Country : US
Telephone Number : 505-688-3389
Fax Number :
Provider Business Practice Location Address
First Line : 3621 MARY ELLEN ST NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-4803
Country : US
Telephone Number : 505-688-3389
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2014
Last Update Date : 01/13/2014

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Directions to “ HERBERT BRUCE BOWMAN RPH” Practice Location

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