Provider Demographics
NPI:1366588972
Name:BOWMAN DRUG COMPANY INCORPORATED
Entity type:Organization
Organization Name:BOWMAN DRUG COMPANY INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:828-464-1354
Mailing Address - Street 1:126 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-2112
Mailing Address - Country:US
Mailing Address - Phone:828-464-1354
Mailing Address - Fax:828-464-7312
Practice Address - Street 1:126 1ST AVE S
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-2112
Practice Address - Country:US
Practice Address - Phone:828-464-1354
Practice Address - Fax:828-464-7312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC070813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0185017Medicaid
2065732OtherPK