Provider Demographics
NPI:1134746217
Name:CROWLEY, JARRED (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:JARRED
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WINTERBERRY DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3271
Mailing Address - Country:US
Mailing Address - Phone:678-572-3548
Mailing Address - Fax:
Practice Address - Street 1:1860 BARNETT SHOALS RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-6811
Practice Address - Country:US
Practice Address - Phone:706-227-6265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist