Provider Demographics
NPI:1245878875
Name:CROWNS PHARMACY LLC
Entity type:Organization
Organization Name:CROWNS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUKWUEDOZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOTCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-237-1144
Mailing Address - Street 1:9705 FORT MEADE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4405
Mailing Address - Country:US
Mailing Address - Phone:509-237-1144
Mailing Address - Fax:
Practice Address - Street 1:9705 FORT MEADE RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4405
Practice Address - Country:US
Practice Address - Phone:509-237-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-13
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty