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General NPI Number Information
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NPI Number | 1831250885
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Entity Type | Organization
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Legal Business Name | CRANE PHARMACY LLC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 515 S ALFORD ST
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City | CRANE
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State | TX
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Zip | 79731-2517
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Country | US
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Telephone | 432-558-2411
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Fax | 432-558-3908
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Provider Business Mailing Address
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Address Line | 515 S ALFORD ST
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City | CRANE
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State | TX
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Zip | 79731-2517
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Country | US
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Telephone | 432-558-2411
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Fax | 432-558-3908
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Authorized Official
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Title or Position | MANAGER
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Name | AARON GIBSON
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Credential |
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Telephone | 432-558-2411
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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 | 30197
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License Number State | TX
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