Provider Demographics
NPI:1477959450
Name:CROWELL, ANGELINA (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:CROWELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7059 DEVINNEY CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-2075
Mailing Address - Country:US
Mailing Address - Phone:303-456-6228
Mailing Address - Fax:
Practice Address - Street 1:14605 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3514
Practice Address - Country:US
Practice Address - Phone:303-209-9010
Practice Address - Fax:303-209-7841
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist