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General NPI Number Information
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NPI Number | 1831511021
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Entity Type | Individual
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Provider Name | CRYSTAL ISAACS PHARM.D., R.PH.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2014
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 1250 PATROL RD STE 100
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City | CHARLESTOWN
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State | IN
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Zip | 47111-8670
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Country | US
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Telephone | 855-647-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 PATROL RD STE 100
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City | CHARLESTOWN
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State | IN
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Zip | 47111-8670
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Country | US
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Telephone | 855-647-7379
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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 | 23743
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 016475
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23647
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26025729A
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License Number State | IN
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