Provider Demographics
NPI:1063736452
Name:CRAIN, STEVEN LOYD (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LOYD
Last Name:CRAIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E PRIMROSE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5154
Mailing Address - Country:US
Mailing Address - Phone:417-269-5584
Mailing Address - Fax:417-268-5582
Practice Address - Street 1:1930 E KEARNEY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-4608
Practice Address - Country:US
Practice Address - Phone:417-862-7750
Practice Address - Fax:417-862-8029
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO040330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist