Healthcare Provider Details

I. General information

NPI: 1073996922
Provider Name (Legal Business Name): CRB HEALTHCARE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 05/15/2024
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S PRESTON RD STE 50
PROSPER TX
75078-2780
US

IV. Provider business mailing address

210 S PRESTON RD STE 50
PROSPER TX
75078-2780
US

V. Phone/Fax

Practice location:
  • Phone: 972-347-6331
  • Fax: 972-347-6332
Mailing address:
  • Phone: 972-347-6331
  • Fax: 972-347-6332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number30067
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VARSHA DESHMUKH
Title or Position: PRESIDENT
Credential:
Phone: 972-347-6331