Provider Demographics
NPI:1073838777
Name:CROUCH, STEVEN C
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:C
Last Name:CROUCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-3305
Mailing Address - Country:US
Mailing Address - Phone:518-773-2649
Mailing Address - Fax:
Practice Address - Street 1:99 EAST STATE STREET
Practice Address - Street 2:NATHAN LITTAUER HOSPITAL PHARMACY
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-773-5577
Practice Address - Fax:518-773-5748
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist