Provider Demographics
NPI:1275255333
Name:OWENS, BROOKE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MINUTEMAN LN
Mailing Address - Street 2:
Mailing Address - City:WOOLWICH TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-4234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 MULLICA HILL RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-4413
Practice Address - Country:US
Practice Address - Phone:856-508-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04263400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist