Provider Demographics
NPI:1386159176
Name:BOWEN HEALTH, INC.
Entity type:Organization
Organization Name:BOWEN HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-267-7169
Mailing Address - Street 1:2621 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-3880
Mailing Address - Country:US
Mailing Address - Phone:574-267-7169
Mailing Address - Fax:
Practice Address - Street 1:1415 DIRECTORS ROW
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46808-1297
Practice Address - Country:US
Practice Address - Phone:800-342-5653
Practice Address - Fax:574-269-4189
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOWEN HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-04
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone