Provider Demographics
NPI:1114139706
Name:CRUMBY, MELVIN E III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:E
Last Name:CRUMBY
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3546
Mailing Address - Country:US
Mailing Address - Phone:479-619-3315
Mailing Address - Fax:479-936-2836
Practice Address - Street 1:1200 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3546
Practice Address - Country:US
Practice Address - Phone:479-619-3315
Practice Address - Fax:479-936-2836
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist