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General NPI Number Information
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NPI Number | 1952875924
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Entity Type | Organization
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Legal Business Name | INNOVATIVE SOLUTIONS R & D LLC
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 23 EURY LN
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City | SOMERSET
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State | KY
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Zip | 42501-4115
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Country | US
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Telephone | 800-401-8213
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Fax | 800-401-8213
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Provider Business Mailing Address
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Address Line | 465 BOSTON RD
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City | MONTICELLO
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State | KY
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Zip | 42633-8321
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Country | US
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Telephone | 606-341-3518
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA GLEN CROWLEY
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Credential | PHARM.D.
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Telephone | 606-341-3518
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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