CRJ Pharmacy, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

PH21511 Issued in FL

Legal business name

CRJ PHARMACY, INC.

Doing business as

CRJ Neighborhood Pharmacy

Practice address

1845 N Crystal Lake Dr
Lakeland, FL 33801-5902

Phone

(863) 669-1329

Fax

(863) 669-1521

NPI assigned

Nov 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Derek Orville O'Bannon

Title

President

Phone

(863) 669-1329

Specialties & licenses 1

Addresses

Other names 1

• CRJ Neighborhood Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942375670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 N CRYSTAL LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015902",
            "telephone_number": "863-669-1329",
            "fax_number": "863-669-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 N CRYSTAL LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015902",
            "telephone_number": "863-669-1329",
            "fax_number": "863-669-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRJ PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'BANNON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "ORVILLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-669-1329",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "PH21511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRJ Neighborhood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Cribbs, BCBA
• Madison M Cribbs
• Philip Andrew Cribbs, RPH
• John A Crist, DPM
• Heather Nichole Cristofaro, APRN
• Vanessa Cromartie
• Lindsey Rai Cromer, APRN, FNP-C
• Brian T Crosby, D.M.D.
• Jennifer Cross
• Tyler Crouch

• Health Maintenance Organization in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.