Provider Demographics
NPI:1184905101
Name:OWENS, MEGAN (RPH)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:OWENS
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 1:1525 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1021
Mailing Address - Country:US
Mailing Address - Phone:239-939-2191
Mailing Address - Fax:239-939-7652
Practice Address - Street 1:1525 COLONIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1021
Practice Address - Country:US
Practice Address - Phone:239-939-2191
Practice Address - Fax:239-939-7652
Is Sole Proprietor?:No
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39908183500000X
NY041385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist