Provider Demographics
NPI:1538670799
Name:CRIM JR., EUGENE
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:CRIM JR.
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7207 TEMPLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-5335
Mailing Address - Country:US
Mailing Address - Phone:202-556-7055
Mailing Address - Fax:
Practice Address - Street 1:7207 TEMPLE HILL RD
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-5335
Practice Address - Country:US
Practice Address - Phone:202-556-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant