Provider Demographics
NPI:1760794499
Name:CROWDER FAMILY HEALTHCARE LLC
Entity Type:Organization
Organization Name:CROWDER FAMILY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:615-374-4700
Mailing Address - Street 1:211 MCMURRY BLVD E
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-1109
Mailing Address - Country:US
Mailing Address - Phone:615-374-4700
Mailing Address - Fax:615-374-4131
Practice Address - Street 1:211 MCMURRY BLVD E
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-1109
Practice Address - Country:US
Practice Address - Phone:615-374-4700
Practice Address - Fax:615-374-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113595261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty