Provider Demographics
NPI:1699055186
Name:CRAWFORD, BRANDON LEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:LEE
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 GREENSIDE CT
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-4583
Mailing Address - Country:US
Mailing Address - Phone:678-372-6602
Mailing Address - Fax:
Practice Address - Street 1:10 E MAY ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-1949
Practice Address - Country:US
Practice Address - Phone:678-425-6954
Practice Address - Fax:678-425-6963
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023056183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist