Provider Demographics
NPI:1831511021
Name:ISAACS, CRYSTAL (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:
Last Name:ISAACS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 PATROL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-8670
Mailing Address - Country:US
Mailing Address - Phone:855-647-7379
Mailing Address - Fax:
Practice Address - Street 1:1250 PATROL RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-8670
Practice Address - Country:US
Practice Address - Phone:855-647-7379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23743183500000X
KY016475183500000X
NV23647183500000X
IN26025729A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist