Healthcare Provider Details

I. General information

NPI: 1972046431
Provider Name (Legal Business Name): RUTH CROWDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 CYPRESS STREET
WEST MONROE LA
71291
US

IV. Provider business mailing address

5350 CYPRESS ST
WEST MONROE LA
71291-7506
US

V. Phone/Fax

Practice location:
  • Phone: 318-396-3530
  • Fax: 318-396-3534
Mailing address:
  • Phone: 318-396-3530
  • Fax: 318-396-3534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number021825
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: