Provider Demographics
NPI:1689018061
Name:CRAWFORD, EDWIN M (R PH)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:M
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 RICHMOND AVE
Mailing Address - Street 2:ATTN: PHARMACY
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-9146
Mailing Address - Country:US
Mailing Address - Phone:540-332-8041
Mailing Address - Fax:540-332-8044
Practice Address - Street 1:1301 RICHMOND AVE
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-9146
Practice Address - Country:US
Practice Address - Phone:540-332-8041
Practice Address - Fax:540-332-8044
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020117231835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric