Provider Demographics
NPI:1992727168
Name:CREWS, KIM (RPH)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:CREWS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 BURT SPUR
Mailing Address - Street 2:
Mailing Address - City:BRIERFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35035-3509
Mailing Address - Country:US
Mailing Address - Phone:205-665-3870
Mailing Address - Fax:
Practice Address - Street 1:1207 STATE ST
Practice Address - Street 2:FRANK'S PHARMACY
Practice Address - City:GREENSBORO
Practice Address - State:AL
Practice Address - Zip Code:36744-2012
Practice Address - Country:US
Practice Address - Phone:334-624-7979
Practice Address - Fax:334-624-7938
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist