Charles Lee Bowman, | |
102 Howard Ave, Mullens, WV 25882-1419 | |
(304) 294-5353 | |
Not Available |
Full Name | Charles Lee Bowman |
---|---|
Gender | Male |
Speciality | Counselor |
Location | 102 Howard Ave, Mullens, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578049151 | NPI | - | NPPES |
0005489001 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Entity Name | Southern Highlands Community Mental Health Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740234673 PECOS PAC ID: 4486629235 Enrollment ID: O20040826000703 |
Mailing Address | Practice Location Address |
---|---|
Charles Lee Bowman, 102 Howard Ave, Mullens, WV 25882-1419 Ph: (304) 294-5353 | Charles Lee Bowman, 102 Howard Ave, Mullens, WV 25882-1419 Ph: (304) 294-5353 |
Justin Tyler Bailey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Howard Ave, Mullens, WV 25882 Phone: 304-294-5353 Fax: 304-294-8627 | |
Romaine Lentz, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Howard Ave, Mullens, WV 25882 Phone: 304-294-5353 | |
Katie Jo Williamson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Howard Ave, Mullens, WV 25882 Phone: 304-294-5353 |