MEDICARE: ANDREA MINH CROW PHARMD

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	174H00000X	Health Educator	11281620-1721	UT
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	0023087	CO
3	183500000X	Pharmacist	0023087	CO

General Provider Information

NPI Number	:	1215582424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MINH CROW PHARMD

Provider Business Mailing Address
First Line	:	905 HIGHWAY 133
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623
Country	:	US
Telephone Number	:	970-233-5208
Fax Number	:	970-233-5209

Provider Business Practice Location Address
First Line	:	905 HIGHWAY 133 CITY MARKET PHARMACY
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623
Country	:	US
Telephone Number	:	970-233-5208
Fax Number	:	970-233-5209

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

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	06/04/2026

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