Provider Demographics
NPI:1649948878
Name:FOWLER, ANGELA VEREB (PHARMD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:VEREB
Last Name:FOWLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:VEREB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1419 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-8062
Mailing Address - Country:US
Mailing Address - Phone:330-505-1979
Mailing Address - Fax:
Practice Address - Street 1:1419 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-8062
Practice Address - Country:US
Practice Address - Phone:330-505-1979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443897183500000X
PARPI001625183500000X
OH03337880183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP443897OtherPA STATE BOARD OF PHARMACY
PARPI001625OtherPA STATE BOARD OF PHARMACY
OH03337880OtherOHIO STATE BOARD OF PHARMACY