MEDICARE: MRS. AMY BOWDEN

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	11022	NC

General Provider Information

NPI Number	:	1891114088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY BOWDEN

Provider Business Mailing Address
First Line	:	530 GROVE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-5140
Country	:	US
Telephone Number	:	910-483-5117
Fax Number	:	910-483-0265

Provider Business Practice Location Address
First Line	:	530 GROVE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-5140
Country	:	US
Telephone Number	:	910-483-5117
Fax Number	:	910-483-0265

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	04/15/2014

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Directions to “ MRS. AMY BOWDEN ” Practice Location

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