Provider Demographics
NPI:1801392758
Name:CROWSON, RONALD WADE SR (PHARM D)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:WADE
Last Name:CROWSON
Suffix:SR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 HIGHWAY 12 S
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-3322
Mailing Address - Country:US
Mailing Address - Phone:615-792-7720
Mailing Address - Fax:615-792-5346
Practice Address - Street 1:1626 HIGHWAY 12 S
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-3322
Practice Address - Country:US
Practice Address - Phone:615-792-7720
Practice Address - Fax:615-792-5346
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2018-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist