Provider Demographics
NPI:1720655178
Name:OWEN MEDICAL SUPPLY
Entity Type:Organization
Organization Name:OWEN MEDICAL SUPPLY
Other - Org Name:OWEN MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:MUYI
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:615-406-1886
Mailing Address - Street 1:265 WHITE BRIDGE PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3205
Mailing Address - Country:US
Mailing Address - Phone:615-454-2955
Mailing Address - Fax:615-600-5182
Practice Address - Street 1:265 WHITE BRIDGE PIKE STE 102
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3205
Practice Address - Country:US
Practice Address - Phone:615-454-2955
Practice Address - Fax:615-600-5182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies