MEDICARE: ANGELA BAILEY ROWSEY

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	183500000X	Pharmacist	E-08803	MS

General Provider Information

NPI Number	:	1710015649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA BAILEY ROWSEY

Provider Business Mailing Address
First Line	:	126 COURT SQUARE
Second Line	:
City	:	CHARLESTON
State	:	MS
Zip	:	38921-2232
Country	:	US
Telephone Number	:	662-783-6100
Fax Number	:	662-783-3007

Provider Business Practice Location Address
First Line	:	315 W MAIN ST
Second Line	:
City	:	CHARLESTON
State	:	MS
Zip	:	38921-2232
Country	:	US
Telephone Number	:	662-647-5541
Fax Number	:	662-647-5546

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	10/31/2019

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