Individual provider Active NPI

Andrew Tyler Croom, PHARMD

  • Pharmacist
  • Greenville, NC
National Provider Identifier
1588276331
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29795 Issued in NC
Practice address
3101 E 10TH St
Greenville, NC 27858-4203
Phone
(252) 695-6253
Fax
(252) 695-6256
NPI assigned
Aug 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29795 NC Primary

Addresses

Primary practice location

3101 E 10TH St
Greenville, NC 27858-4203

Mailing address

3101 E 10TH St
Greenville, NC 27858-4203
Phone (252) 695-6253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
29795NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1588276331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 E 10TH ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278584203",
            "telephone_number": "252-695-6253",
            "fax_number": "252-695-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 E 10TH ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278584203",
            "telephone_number": "252-695-6253",
            "fax_number": "252-695-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOM",
        "first_name": "ANDREW",
        "middle_name": "TYLER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "29795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.