Basic Information
| Provider Information | |||||||||
| NPI: | 1447252119 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | TAFT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 918 MARGARET ST | ||||||||
| Address2: | |||||||||
| City: | CHUBBUCK | ||||||||
| State: | ID | ||||||||
| PostalCode: | 832021648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082383538 | ||||||||
| FaxNumber: | 2082824305 | ||||||||
| Practice Location | |||||||||
| Address1: | 845 W CENTER ST | ||||||||
| Address2: | |||||||||
| City: | POCATELLO | ||||||||
| State: | ID | ||||||||
| PostalCode: | 832044205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082326260 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | P5664 | ID | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.