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NPI Code Detail

MEDICARE: WARREN FOWLER PHARMACIST

MEDICARE: WARREN FOWLER PHARMACIST
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
1183500000XPharmacist9181WI

General Provider Information

NPI Number : 1730464876
Entity Type Code : Individual
Provider Name (Legal Business Name) : WARREN FOWLER PHARMACIST
Provider Business Mailing Address
First Line : 623 VROMAN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3637
Country : US
Telephone Number : 920-498-0318
Fax Number :
Provider Business Practice Location Address
First Line : 464 CARDINAL LN
Second Line :
City : GREEN BAY
State : WI
Zip : 54313-9569
Country : US
Telephone Number : 920-661-9355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2011
Last Update Date : 10/20/2011

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Directions to “ WARREN FOWLER PHARMACIST” Practice Location

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