Provider Demographics
NPI:1528355302
Name:SLOWEY, NATHAN JACKSON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:JACKSON
Last Name:SLOWEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21103 GARY DR
Mailing Address - Street 2:APT 403
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-6121
Mailing Address - Country:US
Mailing Address - Phone:415-987-8447
Mailing Address - Fax:
Practice Address - Street 1:2801 ADELINE ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2204
Practice Address - Country:US
Practice Address - Phone:510-981-8392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist