Provider Demographics
NPI:1629708060
Name:OWENS, AMANDA C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:C
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 1:5185 OLDFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3720
Mailing Address - Country:US
Mailing Address - Phone:765-465-5858
Mailing Address - Fax:
Practice Address - Street 1:208 CORWIN LN
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-6612
Practice Address - Country:US
Practice Address - Phone:765-776-8920
Practice Address - Fax:765-453-8600
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029337A1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care