Richard E Crossett, RPH
Individual provider Active NPI Pharmacist · Macomb, IL
NPI 1780711028 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1780711028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- Practice address
- 118 N Lafayette St
Macomb, IL 61455-2226 - Phone
- (309) 833-2424
- NPI assigned
- Feb 27, 2007
- 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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-032362 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossett Pharmacy, Inc | Pharmacist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | IL | Yes |
Addresses
Primary practice location
118 N Lafayette St
Macomb, IL 61455-2226
Mailing address
22 Indian Trail Rd
Macomb, IL 61455-1022
Phone (309) 837-5281
Other providers in Macomb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.