Healthcare Provider Details

I. General information

NPI: 1942121363
Provider Name (Legal Business Name): ADLER W CRUMRIN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24760 HOSPITAL RD
RED LAKE MN
56671
US

IV. Provider business mailing address

9406 E 900TH AVE
ROBINSON IL
62454-5001
US

V. Phone/Fax

Practice location:
  • Phone: 218-679-3912
  • Fax:
Mailing address:
  • Phone: 618-554-4006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number025842
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: