Provider Demographics
NPI:1093828642
Name:CROWELL FAMILY PHARMACY LLC
Entity type:Organization
Organization Name:CROWELL FAMILY PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-878-6930
Mailing Address - Street 1:313 SAND MOUNTAIN DR E
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-2329
Mailing Address - Country:US
Mailing Address - Phone:256-878-6930
Mailing Address - Fax:256-878-6947
Practice Address - Street 1:313 SAND MOUNTAIN DR E
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2329
Practice Address - Country:US
Practice Address - Phone:256-878-6930
Practice Address - Fax:256-878-6947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1040103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0103604OtherNCPDP PROVIDER IDENTIFICATION NUMBER