Provider Demographics
NPI:1962777334
Name:CRUMP, JAMES SHAW JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SHAW
Last Name:CRUMP
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:602 PLACID LN
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-5800
Mailing Address - Country:US
Mailing Address - Phone:256-738-3034
Mailing Address - Fax:
Practice Address - Street 1:4910 UNIVERSITY SQ
Practice Address - Street 2:SUITE # 3
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-1883
Practice Address - Country:US
Practice Address - Phone:256-738-3034
Practice Address - Fax:256-837-2402
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-18
Last Update Date:2012-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist