Marlise Blanks Crowe, RPH
Individual provider Active NPI Pharmacist · Halifax, VA
NPI 1144388166 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144388166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202004519 (VA)
- Practice address
- 4121 Halifax Road
Halifax, VA 24558 - Phone
- (434) 575-0511
- Fax
- (434) 575-1366
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202004519 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202004519 | VA | Yes |
Addresses
Primary practice location
4121 Halifax Road
Halifax, VA 24558
Mailing address
PO Box 773
Halifax, VA 24558
Phone (434) 575-0511
Other providers in Halifax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.