Provider Demographics
NPI:1578660312
Name:OWENS PHARMACY INC
Entity Type:Organization
Organization Name:OWENS PHARMACY INC
Other - Org Name:OWENS PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-862-4343
Mailing Address - Street 1:515 E RIDGEWAY ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON FORGE
Mailing Address - State:VA
Mailing Address - Zip Code:24422-1328
Mailing Address - Country:US
Mailing Address - Phone:540-862-4343
Mailing Address - Fax:540-863-9220
Practice Address - Street 1:515 E RIDGEWAY ST
Practice Address - Street 2:
Practice Address - City:CLIFTON FORGE
Practice Address - State:VA
Practice Address - Zip Code:24422-1328
Practice Address - Country:US
Practice Address - Phone:540-862-4343
Practice Address - Fax:540-863-9220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
VA02010018433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2102431OtherPK
VA8505241Medicaid
0265270001Medicare NSC