Provider Demographics
NPI:1821375825
Name:CRUMBLE-OWOLABI, ALEXANDRIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:
Last Name:CRUMBLE-OWOLABI
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ALEXANDRIA
Other - Middle Name:NICOLE
Other - Last Name:CRUMBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 17474
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-0474
Mailing Address - Country:US
Mailing Address - Phone:317-490-4477
Mailing Address - Fax:
Practice Address - Street 1:3401 E RAYMOND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-4744
Practice Address - Country:US
Practice Address - Phone:463-268-6337
Practice Address - Fax:463-271-3900
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292936183500000X
IN26030232A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist