NPIMap

Organization Active NPI

Crawford Drug LLC

  • Community/Retail Pharmacy
  • Dorchester Center, MA
National Provider Identifier
1811058985
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1431 Issued in MA
Legal business name
CRAWFORD DRUG LLC
Practice address
1735 Dorchester Ave
Dorchester Center, MA 02124-2535
Phone
(617) 436-3400
Fax
(617) 436-2243
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Authorized official

Name
Stephen Ronald KinanNPI 1235489311
Title
Owner/Pharmacy Manager
Phone
(617) 436-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 1431 MA Primary

Addresses

Primary practice location

1735 Dorchester Ave
Dorchester Center, MA 02124-2535

Mailing address

1735 Dorchester Ave
Dorchester Center, MA 02124-2535
Phone (617) 436-3400

Other identifiers 1

IdentifierTypeStateIssuer
110106701AMedicaidMA

Other names 1

  • CRAWFORD DRUG Other name

National Provider Directory

National Provider Directory

Locations

1735 Dorchester Ave
Dorchester Center, MA 02124
Phone (617) 436-3400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1811058985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 DORCHESTER AVE",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021242535",
            "telephone_number": "617-436-3400",
            "fax_number": "617-436-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 DORCHESTER AVE",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021242535",
            "telephone_number": "617-436-3400",
            "fax_number": "617-436-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD DRUG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "KINAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "OWNER/PHARMACY MANAGER",
        "authorized_official_telephone_number": "617-436-3400"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "1431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110106701A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRAWFORD DRUG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dorchester Center, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.