Provider Demographics
NPI:1962806588
Name:JOWERS, BEN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:JOWERS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:COUSHATTA
Mailing Address - State:LA
Mailing Address - Zip Code:71019-0685
Mailing Address - Country:US
Mailing Address - Phone:318-932-3700
Mailing Address - Fax:318-932-4022
Practice Address - Street 1:1603 RINGGOLD AVE
Practice Address - Street 2:
Practice Address - City:COUSHATTA
Practice Address - State:LA
Practice Address - Zip Code:71019-9084
Practice Address - Country:US
Practice Address - Phone:318-932-5771
Practice Address - Fax:318-932-4022
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.010878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist