Provider Demographics
NPI:1396345344
Name:CROWE, MARIANNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:
Last Name:CROWE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23630 US HIGHWAY 80 E
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30461-6019
Mailing Address - Country:US
Mailing Address - Phone:912-536-7052
Mailing Address - Fax:
Practice Address - Street 1:23630 US HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30461-6019
Practice Address - Country:US
Practice Address - Phone:912-764-2223
Practice Address - Fax:912-764-2228
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist