Provider Demographics
NPI:1730482894
Name:CRESCENT PHARMACY OF ROWAN INC.
Entity Type:Organization
Organization Name:CRESCENT PHARMACY OF ROWAN INC.
Other - Org Name:CRESCENT PHARMACY OF ROWAN INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-279-2288
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28138-0489
Mailing Address - Country:US
Mailing Address - Phone:704-279-2288
Mailing Address - Fax:704-279-0881
Practice Address - Street 1:314 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:NC
Practice Address - Zip Code:28138
Practice Address - Country:US
Practice Address - Phone:704-279-2288
Practice Address - Fax:704-279-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3458204OtherNCPDP PROVIDER IDENTIFICATION NUMBER