Healthcare Provider Details

I. General information

NPI: 1396379038
Provider Name (Legal Business Name): JARED CRUMB PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 CHARLOTTE AVE
NASHVILLE TN
37203-1816
US

IV. Provider business mailing address

2108 CHARLOTTE AVE
NASHVILLE TN
37203-1816
US

V. Phone/Fax

Practice location:
  • Phone: 615-986-7650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number40332
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: