Active NPI
Kenneth Earl Crawford III, RPH
- Pharmacist
- Laurel, MS
National Provider Identifier
1891901567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E08765
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| E08765 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crawford Professional Drugs Inc | Current | Accepting new patients | |
| Wallace Drug Company Inc | Past | 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.
-
- Community/Retail Pharmacy
- Laurel, MS
- NPI 1992879415
-
- Community/Retail Pharmacy
- Laurel, MS
- NPI 1710622865
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.