Provider Demographics
NPI:1063002228
Name:CRAVEY, BEN D JR (RPH)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:D
Last Name:CRAVEY
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036-8420
Mailing Address - Country:US
Mailing Address - Phone:478-892-9021
Mailing Address - Fax:478-892-9156
Practice Address - Street 1:115 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036-8420
Practice Address - Country:US
Practice Address - Phone:478-892-9021
Practice Address - Fax:478-892-9156
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH012850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist