MEDICARE: MR. DAVID EARL 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
1	183500000X	Pharmacist	7325	KY

General Provider Information

NPI Number	:	1710233580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID EARL BOWMAN RPH

Provider Business Mailing Address
First Line	:	803 BURKESVILLE ST
Second Line	:
City	:	COLUMBIA
State	:	KY
Zip	:	42728-1655
Country	:	US
Telephone Number	:	270-384-2117
Fax Number	:	270-384-5636

Provider Business Practice Location Address
First Line	:	803 BURKESVILLE ST
Second Line	:
City	:	COLUMBIA
State	:	KY
Zip	:	42728-1655
Country	:	US
Telephone Number	:	270-384-2117
Fax Number	:	270-384-5636

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

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	07/31/2012

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