Red Crown I I I Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008602 Issued in MI

Legal business name

RED CROWN I I I INC

Practice address

635 W Broad St
Linden, MI 48451-8644

Phone

(810) 735-0800

Fax

(810) 735-0902

NPI assigned

Aug 27, 2006

Organization subpart

No

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

Authorized official

Name

Eric Graham

Title

Owner

Phone

(810) 735-0800

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RED CROWN PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1881702256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W BROAD ST",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518644",
            "telephone_number": "810-735-0800",
            "fax_number": "810-735-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W BROAD ST",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518644",
            "telephone_number": "810-735-0800",
            "fax_number": "810-735-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CROWN I I I INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-735-0800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2365698",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2365698",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RED CROWN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Linden, MI
• Providers in Linden, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.