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General NPI Number Information
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NPI Number | 1235723875
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Entity Type | Individual
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Provider Name | CRYSTAL BELL PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 534 WOODLAWN RD
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City | LINCOLN
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State | IL
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Zip | 62656-1405
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Country | US
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Telephone | 217-735-1548
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Fax |
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Provider Business Mailing Address
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Address Line | 413 N ELM ST
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City | TALLULA
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State | IL
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Zip | 62688-9772
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Country | US
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Telephone | 314-750-0805
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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 | 051299306
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License Number State | IL
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