Provider Demographics
NPI:1609088483
Name:CASCADDEN, CRYSTAL JO (RPH)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:JO
Last Name:CASCADDEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 JENNESS HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:NH
Mailing Address - Zip Code:03222-3810
Mailing Address - Country:US
Mailing Address - Phone:603-744-9047
Mailing Address - Fax:
Practice Address - Street 1:16 HOSPITAL RD
Practice Address - Street 2:SPEARE MEMORIAL HOSPITAL
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1126
Practice Address - Country:US
Practice Address - Phone:603-238-2226
Practice Address - Fax:603-238-6419
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
NH2440183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy