Provider Demographics
NPI:1306941885
Name:CROOK, STACY P (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:P
Last Name:CROOK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MS
Other - First Name:STACY
Other - Middle Name:P
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1011 GRAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022
Mailing Address - Country:US
Mailing Address - Phone:205-425-3815
Mailing Address - Fax:205-425-2021
Practice Address - Street 1:2910 MORGAN RD
Practice Address - Street 2:STE 128
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022
Practice Address - Country:US
Practice Address - Phone:205-425-2828
Practice Address - Fax:205-425-2021
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist