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General NPI Number Information
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NPI Number | 1346378668
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Entity Type | Organization
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Legal Business Name | CRAWFORDS PHARMACY INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2260 CHAMBLISS AVE NW
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City | CLEVELAND
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State | TN
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Zip | 37311
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Country | US
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Telephone | 423-479-8601
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3326
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City | CLEVELAND
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State | TN
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Zip | 37320-3326
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Country | US
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Telephone | 423-479-8601
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFRY H WOLFENDEN
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Credential | RPH
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Telephone | 423-479-8601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 215
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License Number State | TN
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