Individual provider Active NPI

Kenneth Earl Crawford III, RPH

  • Pharmacist
  • Laurel, MS
National Provider Identifier
1891901567
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E08765 Issued in MS
Practice address
1107 Jefferson St
Laurel, MS 39440-4352
Phone
(601) 425-2527
Fax
(601) 425-2528
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E08765 MS Primary

Addresses

Primary practice location

1107 Jefferson St
Laurel, MS 39440-4352

Mailing address

1107 Jefferson St
Laurel, MS 39440-4352
Phone (601) 425-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
E08765MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Professional Drugs Inc Current Accepting new patients
Wallace Drug Company Inc PastSince May 8, 2022 Accepting new patients

Locations

1107 Jefferson St
Laurel, MS 39440
Phone (601) 425-2527

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891901567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404352",
            "telephone_number": "601-425-2527",
            "fax_number": "601-425-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404352",
            "telephone_number": "601-425-2527",
            "fax_number": "601-425-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KENNETH",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E08765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.