Provider Demographics
NPI:1972192201
Name:CROWELL, RODNEY KEITH (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:KEITH
Last Name:CROWELL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 SAND MOUNTAIN DR E
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-2371
Mailing Address - Country:US
Mailing Address - Phone:256-878-6930
Mailing Address - Fax:
Practice Address - Street 1:313 SAND MOUNTAIN DR E
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2371
Practice Address - Country:US
Practice Address - Phone:125-687-8693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist