Healthcare Provider Details

I. General information

NPI: 1578660312
Provider Name (Legal Business Name): OWENS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 E RIDGEWAY ST
CLIFTON FORGE VA
24422-1328
US

IV. Provider business mailing address

515 E RIDGEWAY ST
CLIFTON FORGE VA
24422-1328
US

V. Phone/Fax

Practice location:
  • Phone: 540-862-4343
  • Fax: 540-863-9220
Mailing address:
  • Phone: 540-862-4343
  • Fax: 540-863-9220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201001843
License Number StateVA

VIII. Authorized Official

Name: CHARLES KAHLE
Title or Position: PRESIDENT PHARMACIST
Credential:
Phone: 540-862-4343