Provider Demographics
NPI:1659028884
Name:CROWNEDTWO LLC.
Entity Type:Organization
Organization Name:CROWNEDTWO LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRALETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-747-3554
Mailing Address - Street 1:2200 PIKES PEAK BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-1168
Mailing Address - Country:US
Mailing Address - Phone:404-747-3554
Mailing Address - Fax:
Practice Address - Street 1:2200 PIKES PEAK BLVD APT 3
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1168
Practice Address - Country:US
Practice Address - Phone:770-681-3887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment