Justin Crouch, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

58922 Issued in TX

Practice address

3030 E 29TH St Ste 100
Bryan, TX 77802-2740

Phone

(979) 846-8199

NPI assigned

Jan 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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

• Village Foods LTD

  • Community/Retail Pharmacy
  • Bryan, TX
  • NPI 1528104148
  NPD

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1700477148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 ASHVILLE PATH",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778081448",
            "telephone_number": "979-324-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 E 29TH ST STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022740",
            "telephone_number": "979-846-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "58922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pharmacy@villagefoods.com",
            "affiliation": "N",
            "address_1": "3030 E 29th St Ste 100",
            "city": "Bryan",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778022740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Abigail Crisanto, RN
• Pamela Proctor Criscitiello, AGPCNP, MSN, RN, OCN
• Joe D Crnkovic, ACA
• Joseph Daniel Crnkovic II
• Nicole Rae Crnkovic
• Shameka Crump
• Charles Douglas Crumpler Jr., M.D.
• Irma Janette Cruz
• Crystal Tindall FNP PLLC
• Jennifer Lea Culver, M.D.

• Pharmacist in Bryan, TX
• Providers in Bryan, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.