MEDICARE: CRESTVIEW PHARMACY LLC

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	333600000X	Pharmacy	27870	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5905508	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1962778738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESTVIEW PHARMACY LLC

Provider Business Mailing Address
First Line	:	7100 WOODROW AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-1802
Country	:	US
Telephone Number	:	512-452-9535
Fax Number	:	512-452-9583

Provider Business Practice Location Address
First Line	:	7100 WOODROW AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-1802
Country	:	US
Telephone Number	:	512-452-9535
Fax Number	:	512-452-9583

Authorized Official
Title or Position	:	MR
Name	:	JERRY HARPER
Credential	:
Telephone Number	:	512-452-9535

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	03/27/2012

Similar Medicare Providers

1144305681 — DR. WILLIAM R. JOHNSON DDS
Practice Location Address:

1802 W ANDERSON LN
AUSTIN, TX
78757-1338

Practice Phone: 512-459-4347
Practice Fax:

1184744344 — CRESTVIEW PHARMACY, LLC
Practice Location Address:

7100 WOODROW AVE
AUSTIN, TX
78757-1802

Practice Phone: 512-452-9535
Practice Fax: 512-452-9583

1720368103 — ANDERSON LANE DENTAL
Practice Location Address:

1802 W ANDERSON LN
AUSTIN, TX
78757-1338

Practice Phone: 512-459-4347
Practice Fax:

1285915413 — TEXDENTGROUP
Practice Location Address:

1802 ANDERSON LANE
AUSTIN, TX
78757

Practice Phone: 512-459-4347
Practice Fax: 512-459-4348

1558611087 — DR. GERALD BERNARD PEVOW DMD
Practice Location Address:

1802 W ANDERSON LN
AUSTIN, TX
78757-1338

Practice Phone: 512-459-4347
Practice Fax: 512-459-4348

1457772816 — ANDERSON LANE DENTAL CENTER PLLC
Practice Location Address:

1802 W ANDERSON LN
AUSTIN, TX
78757-1338

Practice Phone: 512-459-4347
Practice Fax: 512-459-4348

Directions to “CRESTVIEW PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.