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General NPI Number Information
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NPI Number | 1174736177
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Entity Type | Individual
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Provider Name | SUZANNE MARIE CRASE PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 90 FIFTH ST.
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City | DOUGLAS
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State | AZ
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Zip | 85607
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Country | US
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Telephone | 520-364-7568
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Fax | 520-364-9053
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Provider Business Mailing Address
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Address Line | PO BOX 1621
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City | BISBEE
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State | AZ
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Zip | 85603-2621
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Country | US
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Telephone | 520-432-3560
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12558
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License Number State | AZ
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