Provider Demographics
NPI:1356530869
Name:OWEN, JULIA A (RPH)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:OWEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15224 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2415
Mailing Address - Country:US
Mailing Address - Phone:515-975-6093
Mailing Address - Fax:515-285-8974
Practice Address - Street 1:4121 FLEUR DR
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50321-2301
Practice Address - Country:US
Practice Address - Phone:515-285-5927
Practice Address - Fax:515-285-8974
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-21
Last Update Date:2007-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist