Healthcare Provider Details

I. General information

NPI: 1861708067
Provider Name (Legal Business Name): TIMOTHY MICHAEL CROWLEY RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 HURFFVILLE CROSSKEYS RD
SEWELL NJ
08080-2342
US

IV. Provider business mailing address

490 HURFFVILLE CROSSKEYS RD
SEWELL NJ
08080-2342
US

V. Phone/Fax

Practice location:
  • Phone: 856-589-8466
  • Fax: 856-218-0493
Mailing address:
  • Phone: 856-589-8466
  • Fax: 856-218-0493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02653600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS48644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: