Provider Demographics
NPI:1700123924
Name:OWED, JAMIE ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ANN
Last Name:OWED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ANN
Other - Last Name:GOECKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2607 RAVENSCROFT WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8299
Mailing Address - Country:US
Mailing Address - Phone:434-985-3914
Mailing Address - Fax:
Practice Address - Street 1:1980 RIO HILL CTR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1144
Practice Address - Country:US
Practice Address - Phone:434-978-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012846183500000X
GA018741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist