Provider Demographics
NPI:1114294469
Name:CROWDER-KING, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:CROWDER-KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 GREEN TREE RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1166
Mailing Address - Country:US
Mailing Address - Phone:484-690-9740
Mailing Address - Fax:
Practice Address - Street 1:121 GREEN TREE RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1166
Practice Address - Country:US
Practice Address - Phone:484-690-9740
Practice Address - Fax:484-927-8714
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042669L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist