Provider Demographics
NPI:1841747441
Name:CRUPIE, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CRUPIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11051 BELAIRE DR
Mailing Address - Street 2:
Mailing Address - City:N HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-6328
Mailing Address - Country:US
Mailing Address - Phone:724-493-7077
Mailing Address - Fax:
Practice Address - Street 1:1901 LINCOLN HIGHWAY
Practice Address - Street 2:
Practice Address - City:N. VERSAILLES
Practice Address - State:PA
Practice Address - Zip Code:15137
Practice Address - Country:US
Practice Address - Phone:412-823-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP414497L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist