Provider Demographics
NPI:1689132409
Name:CROWN MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:CROWN MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-668-8750
Mailing Address - Street 1:1031 S BLUFF ST STE 222
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-5206
Mailing Address - Country:US
Mailing Address - Phone:435-634-8865
Mailing Address - Fax:435-634-8866
Practice Address - Street 1:1031 S BLUFF ST STE 222
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-5206
Practice Address - Country:US
Practice Address - Phone:435-634-8865
Practice Address - Fax:435-634-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies