Individual ProviderAugustine OwusuPharmacistPharmacy Service ProvidersPractice Address5415 S Broadway Ave, Tyler, TX 75703-1397(903) 939-9298PECOS EnrollmentBased on the most recent information from CMS, provider Augustine Owusu does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1437515400Provider TypeIndividualFull NameOwusu, AugustineCredentialPHARM.DGenderMaleSole ProprietorYesEnumeration Date1/6/2016Last Updated1/6/2016Contact InformationPractice LocationPractice Address5415 S Broadway Ave, Tyler, TX 75703-1397Phone(903) 939-9298FaxUnlisted FaxMailing LocationMailing Address5415 S Broadway Ave, Tyler, TX 75703-1397Phone(903) 939-9298FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense57565Texas