Provider Demographics
NPI:1215582424
Name:CROW, ANDREA MINH (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MINH
Last Name:CROW
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MINH
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:905 HIGHWAY 133
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623
Mailing Address - Country:US
Mailing Address - Phone:970-233-5208
Mailing Address - Fax:970-233-5209
Practice Address - Street 1:905 HIGHWAY 133 CITY MARKET PHARMACY
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623
Practice Address - Country:US
Practice Address - Phone:970-233-5208
Practice Address - Fax:970-233-5209
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11281620-1721174H00000X, 183500000X
CO0023087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No174H00000XOther Service ProvidersHealth Educator