1477523132 NPI number — CATHERINE S BOWDEN O.D.

Table of content: CATHERINE S BOWDEN O.D. (NPI 1477523132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477523132 NPI number — CATHERINE S BOWDEN O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWDEN
Provider First Name:
CATHERINE
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477523132
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 HALTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29607-3403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-458-7956
Provider Business Mailing Address Fax Number:
864-458-8390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 S PENDLETON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASLEY
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29640-3048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-859-3233
Provider Business Practice Location Address Fax Number:
864-850-4001
Provider Enumeration Date:
01/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  0910 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 410024412 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 4489610 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: D09104 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4460247002 . This is a "CIGNA PROVIDER NUMBER" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com