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General NPI Number Information
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NPI Number | 1912295155
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Entity Type | Individual
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Provider Name | WILLIAM E CROUCH JR. CPHT
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Gender | Male
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 4300 WEST 7TH STREET VA MEDICAL CENTER ( PHARMACY 119/LR )
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-257-6335
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Fax | 501-257-5012
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Provider Business Mailing Address
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Address Line | PO BOX 1031
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City | CARLISLE
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State | AR
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Zip | 72024-1031
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Country | US
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Telephone | 501-257-6335
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Fax | 501-257-5012
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 360101060765236
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License Number State | AR
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