Provider Demographics
NPI:1265313191
Name:CROWNED PATHWAYS INC
Entity type:Organization
Organization Name:CROWNED PATHWAYS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-979-0068
Mailing Address - Street 1:2219 WALDEN DR APT D1
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-5267
Mailing Address - Country:US
Mailing Address - Phone:229-319-7491
Mailing Address - Fax:
Practice Address - Street 1:2219 WALDEN DR APT D1
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-5267
Practice Address - Country:US
Practice Address - Phone:229-319-7491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies