Provider Demographics
NPI:1467738021
Name:CROWE, RICHARD RELDA JR (RPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:RELDA
Last Name:CROWE
Suffix:JR
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 1:1 GRANITE PL STE N200
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3274
Mailing Address - Country:US
Mailing Address - Phone:603-226-8686
Mailing Address - Fax:603-225-6579
Practice Address - Street 1:1 GRANITE PL STE N200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3274
Practice Address - Country:US
Practice Address - Phone:603-226-8686
Practice Address - Fax:603-225-6579
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH 03242183500000X
NHR1297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist