Larry D Croll, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

11714 Issued in AZ

Practice address

51St Ave and Beltline Rd
Gila Crossing Health Center Pharmacy Pob 380
Laveen, AZ 85339-0380

Phone

(602) 528-1422

Fax

(602) 528-3363

NPI assigned

Jan 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gila Crossing Clinic Phcy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Laveen, AZ
  • NPI 1841206257
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417000969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 380",
            "address_2": "GILA CROSSING HEALTH CENTER PHARMACY",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853390380",
            "telephone_number": "602-528-1422",
            "fax_number": "602-528-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51ST AVE AND BELTLINE RD",
            "address_2": "GILA CROSSING HEALTH CENTER PHARMACY POB 380",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853390380",
            "telephone_number": "602-528-1422",
            "fax_number": "602-528-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROLL",
        "first_name": "LARRY",
        "middle_name": "D",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "11714",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "3812",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "11714",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "3812",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.