Provider Demographics
NPI:1194800706
Name:CRENSHAW DRUGS INC
Entity type:Organization
Organization Name:CRENSHAW DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:V MERRILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CULVERHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-335-5888
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:AL
Mailing Address - Zip Code:36049-0067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1440 S FOREST AVE
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049
Practice Address - Country:US
Practice Address - Phone:334-335-5888
Practice Address - Fax:334-335-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
AL1124803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0132465OtherOTHER ID NUMBER
AL100003555Medicaid