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General NPI Number Information
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NPI Number | 1689756462
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Entity Type | Organization
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Legal Business Name | FULCRUM PHARMACY MANAGEMENT INC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 501 N SHIPLEY ST UNIT 1
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City | WILMINGTON
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State | DE
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Zip | 19801-2252
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Country | US
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Telephone | 302-658-8020
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Fax | 302-658-8024
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Provider Business Mailing Address
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Address Line | PO BOX 2695
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City | WILMINGTON
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State | DE
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Zip | 19805-0695
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Country | US
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Telephone | 302-658-8020
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Fax | 302-658-8024
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTY CRKVENAC
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Credential |
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Telephone | 302-658-8020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | A30000888
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License Number State | DE
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