Provider Demographics
NPI:1255618419
Name:CRAINICH, STEVEN (RPH)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:CRAINICH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 HIGHWAY 119
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-5366
Mailing Address - Country:US
Mailing Address - Phone:205-664-4584
Mailing Address - Fax:205-664-5095
Practice Address - Street 1:9301 HIGHWAY 119
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-5366
Practice Address - Country:US
Practice Address - Phone:205-664-4584
Practice Address - Fax:205-664-5095
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS25167183500000X
AL14686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist