Provider Demographics
NPI:1881048858
Name:OWENS THERAPEUTIC SERVICES, LLC
Entity type:Organization
Organization Name:OWENS THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-289-8229
Mailing Address - Street 1:1661 WALKUP AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-3600
Mailing Address - Country:US
Mailing Address - Phone:704-289-8229
Mailing Address - Fax:704-289-5884
Practice Address - Street 1:1661 WALKUP AVE STE E
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3600
Practice Address - Country:US
Practice Address - Phone:704-289-8229
Practice Address - Fax:704-289-5884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
NC376J00000X, 253Z00000X
NCHC4842253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty