MEDICARE: EJ CRAWFORD ENTERPRISES, LLC

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1790635910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EJ CRAWFORD ENTERPRISES, LLC

Provider Business Mailing Address
First Line	:	216 BASSWOOD AVE
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-4450
Country	:	US
Telephone Number	:	854-296-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 BASSWOOD AVE
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-4450
Country	:	US
Telephone Number	:	843-452-1824
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ELONA COLETTE CRAWFORD
Credential	:
Telephone Number	:	843-452-1824

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	02/05/2026

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