Provider Demographics
NPI:1710640461
Name:HERZOG CRAWFORD AND FLYNN, LLC
Entity Type:Organization
Organization Name:HERZOG CRAWFORD AND FLYNN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAHARI
Authorized Official - Middle Name:MALEK
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:443-824-4788
Mailing Address - Street 1:101 THRESHER DR UNIT 544
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-1985
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:730 ENDERWOOD PL
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-1177
Practice Address - Country:US
Practice Address - Phone:443-824-4788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty