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General NPI Number Information
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NPI Number | 1487759767
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Entity Type | Organization
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Legal Business Name | CROWDERS EXPRESS SCRIPTS
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1514 G ST
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City | BEDFORD
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State | IN
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Zip | 47421
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Country | US
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Telephone | 812-275-5949
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Fax | 812-275-0435
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Provider Business Mailing Address
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Address Line | PO BOX 966
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City | BEDFORD
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State | IN
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Zip | 47421-0966
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | STEVEN ANDERSON
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Credential |
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Telephone | 812-275-5949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | 60005490
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License Number State | IN
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