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General NPI Number Information
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NPI Number | 1205261146
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Entity Type | Organization
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Legal Business Name | CRISIS CONTROL MINISTRY INC
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 200 E 10TH ST
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City | WINSTON SALEM
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State | NC
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Zip | 27101-1512
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Country | US
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Telephone | 336-770-1628
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Fax | 336-770-1630
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Provider Business Mailing Address
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Address Line | 200 EAST 10TH STREER
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City | WINSTON SALEM
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State | NC
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Zip | 27101
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Country | US
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Telephone | 336-770-1628
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Fax | 336-770-1630
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | CATHERINE CRAIGWILDER
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Credential |
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Telephone | 336-770-1628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 04726
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License Number State | NC
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