Healthcare Provider Details

I. General information

NPI: 1245635523
Provider Name (Legal Business Name): JARRED CRUME PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BELTLINE RD SE
DECATUR AL
35601-6504
US

IV. Provider business mailing address

119 TIDMORE AVE
ONEONTA AL
35121-1331
US

V. Phone/Fax

Practice location:
  • Phone: 256-350-3201
  • Fax: 256-584-6804
Mailing address:
  • Phone: 256-778-2486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000036036
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: