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General NPI Number Information
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NPI Number | 1881710697
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Entity Type | Individual
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Provider Name | RANDY ELMER CRUME RPH
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 785 S COLUMBIA RIVER HWY
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City | SAINT HELENS
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State | OR
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Zip | 97051-2928
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Country | US
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Telephone | 503-397-6787
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Fax | 503-366-0610
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Provider Business Mailing Address
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Address Line | PO BOX 712
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City | RAINIER
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State | OR
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Zip | 97048-0712
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Country | US
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Telephone | 503-556-3720
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Fax | 503-366-0610
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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 | 0006427
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License Number State | OR
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