Provider Demographics
NPI:1881433902
Name:CREWS, JAMES LARRY III (PHARMD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LARRY
Last Name:CREWS
Suffix:III
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 MALBORO RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-1611
Mailing Address - Country:US
Mailing Address - Phone:731-676-5616
Mailing Address - Fax:
Practice Address - Street 1:798 W SERVICE RD
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1727
Practice Address - Country:US
Practice Address - Phone:870-735-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD16702183500000X
TN47549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist