Provider Demographics
NPI:1770140477
Name:OWENS, ALEX BERNARD JR
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:BERNARD
Last Name:OWENS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 JEHOSSEE ST APT 201
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5955
Mailing Address - Country:US
Mailing Address - Phone:813-557-2109
Mailing Address - Fax:
Practice Address - Street 1:3021 JEHOSSEE ST APT 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5955
Practice Address - Country:US
Practice Address - Phone:813-557-2109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator