Ryan D Crouch, PHARMD
Individual provider Active NPI Pharmacist · Clarksville, TN
NPI 1992256283 · NPPES record last updated Oct 21, 2016
Key facts
- NPI
- 1992256283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 40146 (TN)
- Practice address
- 110 Dover Crossing Rd
Clarksville, TN 37042-4165 - Phone
- (931) 920-8684
- NPI assigned
- Oct 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40146 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | Past | Accepting new patients | |
| Kroger Limited Partnership I | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 40146 | TN | Yes |
Addresses
Primary practice location
110 Dover Crossing Rd
Clarksville, TN 37042-4165
Mailing address
110 Dover Crossing Rd
Clarksville, TN 37042-4165
Phone (931) 920-8684
Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.