MEDICARE: MRS. CAMILLE OWENS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03440530	OH

General Provider Information

NPI Number	:	1851054621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAMILLE OWENS PHARMD

Provider Business Mailing Address
First Line	:	114 N 17TH ST APT 202
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43203-1922
Country	:	US
Telephone Number	:	614-313-2380
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 N 17TH ST APT 202
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43203-1922
Country	:	US
Telephone Number	:	614-313-2380
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2021
Last Update Date	:	10/19/2021

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