Jesse Crosby, PHARMD
Individual provider Active NPI Pharmacist · Atlanta, GA
NPI 1487301602 · NPPES record last updated Mar 8, 2022
Key facts
- NPI
- 1487301602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH030611 (GA)
- Practice address
- 1529 Piedmont Ave NE Ste C
Atlanta, GA 30324-5000 - Phone
- (404) 461-9105
- Fax
- (404) 881-0006
- NPI assigned
- Mar 8, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH030611 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Community Pharmacy Corp | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH030611 | GA | Yes |
Addresses
Primary practice location
1529 Piedmont Ave NE Ste C
Atlanta, GA 30324-5000
Mailing address
1529 Piedmont Ave NE Ste C
Atlanta, GA 30324-5000
Phone (404) 461-9105
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2022. 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.