Provider Demographics
NPI:1093866410
Name:CROWE, SANDRA SARTAIN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SARTAIN
Last Name:CROWE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PELZER HWY
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-2106
Mailing Address - Country:US
Mailing Address - Phone:864-855-6856
Mailing Address - Fax:
Practice Address - Street 1:410 PELZER HWY
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-2106
Practice Address - Country:US
Practice Address - Phone:864-855-6856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5006183500000X
GA013120183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist