Provider Demographics
NPI:1376051912
Name:CROWN MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:CROWN MEDICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-207-4004
Mailing Address - Street 1:2741 LEMON GROVE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-2976
Mailing Address - Country:US
Mailing Address - Phone:619-207-4004
Mailing Address - Fax:
Practice Address - Street 1:2741 LEMON GROVE AVE STE 101
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-2976
Practice Address - Country:US
Practice Address - Phone:619-207-4004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies