Provider Demographics
NPI:1811143472
Name:OWENS, CEDRIC BRANDON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:BRANDON
Last Name:OWENS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3639
Mailing Address - Country:US
Mailing Address - Phone:812-283-1389
Mailing Address - Fax:
Practice Address - Street 1:934 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3639
Practice Address - Country:US
Practice Address - Phone:812-283-1389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022924A183500000X
KY014182183500000X
FLPS43845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist