Provider Demographics
NPI:1932761889
Name:CRANE, DOUGLAS R (RPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:R
Last Name:CRANE
Suffix:
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 1:1314 E 7TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-2533
Mailing Address - Country:US
Mailing Address - Phone:260-925-8000
Mailing Address - Fax:260-925-9500
Practice Address - Street 1:1314 E 7TH ST STE 104
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2533
Practice Address - Country:US
Practice Address - Phone:260-925-8000
Practice Address - Fax:260-925-9500
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26002117A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist