Provider Demographics
NPI:1194270330
Name:BOWEN, TAYLOR (PHARM D)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 FORUM DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7951
Mailing Address - Country:US
Mailing Address - Phone:803-699-8332
Mailing Address - Fax:
Practice Address - Street 1:29 GREEN SPRINGS CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6940
Practice Address - Country:US
Practice Address - Phone:843-373-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC68798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist