Crandall City Market Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

26418 Issued in TX

Legal business name

CRANDALL CITY MARKET INC

Doing business as

City Market

Practice address

3563 Alton Rd
Fort Worth, TX 76109-2834

Phone

(817) 429-2571

Fax

(817) 921-6075

NPI assigned

May 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kurt Jaeger, RPH

Title

Owner & President

Phone

(817) 429-2571

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• City Market Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1255566287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E RENFRO ST",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760283917",
            "telephone_number": "817-295-1051",
            "fax_number": "817-295-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3563 ALTON RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761092834",
            "telephone_number": "817-429-2571",
            "fax_number": "817-921-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANDALL CITY MARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "OWNER & PRESIDENT",
        "authorized_official_telephone_number": "817-429-2571",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255566287",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4552281",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Market",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Craig, CPNP
• Joshua Craig, LPC
• Lynellen C Craig, RN
• Susan Craig, FAMILY NURSE PRACTIT
• Joe Howard Crain, D.D.S., M.S.
• Benjamin Merrick Crandall, DO
• Pege R Crane, CPNP
• Cranefaulkner LLC
• Jamie Cranfill
• Katy Cranfill

• Community/Retail Pharmacy in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.