Provider Demographics
NPI:1104524735
Name:CRAWFORD, TAMEKA ROSHAWN
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:ROSHAWN
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35023-2254
Mailing Address - Country:US
Mailing Address - Phone:205-835-2160
Mailing Address - Fax:
Practice Address - Street 1:212 B Y WILLIAMS SR DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35228-2221
Practice Address - Country:US
Practice Address - Phone:205-835-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALI30924174400000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No174400000XOther Service ProvidersSpecialist