Healthcare Provider Details

I. General information

NPI: 1396364477
Provider Name (Legal Business Name): LUCIA D OWENS PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 KENTON STATION DR
MAYSVILLE KY
41056-9617
US

IV. Provider business mailing address

8031 DAY PIKE
MAYSVILLE KY
41056-9228
US

V. Phone/Fax

Practice location:
  • Phone: 606-759-1189
  • Fax:
Mailing address:
  • Phone: 606-541-0904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number020701
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: