Red Crown I, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008128 Issued in MI

Legal business name

RED CROWN I, INC

Doing business as

Red Crown Pharmacy

Practice address

4206 Stadium Dr
Kalamazoo, MI 49008-1446

Phone

(269) 488-2630

Fax

(269) 488-2631

NPI assigned

May 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Eric M Graham, RPH

Title

President

Phone

(269) 488-2630

Specialties & licenses 4

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": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1891798401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081446",
            "telephone_number": "269-488-2630",
            "fax_number": "269-488-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081446",
            "telephone_number": "269-488-2630",
            "fax_number": "269-488-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CROWN I, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-488-2630",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5447160001",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008128",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301008128",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "MI",
            "license": "5301008128",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2367008",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4833406",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Crown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Patrick R Reddan, MD
• Emmalee Redder
• Padma P Reddy, MD
• Kathryn Elise Redinger, MD
• Michael James Redinger, MD

• Community/Retail Pharmacy in Kalamazoo, MI
• Providers in Kalamazoo, 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 20, 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.