MEDICARE: DR. LORI SHEREE CRUM PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	47260	CA

General Provider Information

NPI Number	:	1093126625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI SHEREE CRUM PHARM.D.

Provider Business Mailing Address
First Line	:	1842 FORT JONES RD
Second Line	:
City	:	YREKA
State	:	CA
Zip	:	96097-9531
Country	:	US
Telephone Number	:	530-842-4182
Fax Number	:	530-842-6817

Provider Business Practice Location Address
First Line	:	1842 FORT JONES RD
Second Line	:
City	:	YREKA
State	:	CA
Zip	:	96097-9531
Country	:	US
Telephone Number	:	530-842-4182
Fax Number	:	530-842-6817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2014
Last Update Date	:	05/16/2014

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