MEDICARE: DR EDWARD E CROWE OD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618000490	VA

General Provider Information

NPI Number	:	1235302605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR EDWARD E CROWE OD PC

Provider Business Mailing Address
First Line	:	PO BOX 795
Second Line	:
City	:	SOUTH BOSTON
State	:	VA
Zip	:	24592-0795
Country	:	US
Telephone Number	:	434-575-7360
Fax Number	:	434-575-7618

Provider Business Practice Location Address
First Line	:	1328 SEYMOUR DR
Second Line	:
City	:	SOUTH BOSTON
State	:	VA
Zip	:	24592-3914
Country	:	US
Telephone Number	:	434-575-7360
Fax Number	:	434-575-7618

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. ANN CHITWOOD STONEMAN
Credential	:
Telephone Number	:	434-575-7360

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	09/07/2010

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