Provider Demographics
NPI:1730930892
Name:SHAW'S PHARMACY-CROWELL
Entity type:Organization
Organization Name:SHAW'S PHARMACY-CROWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:940-684-1581
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:CROWELL
Mailing Address - State:TX
Mailing Address - Zip Code:79227-0129
Mailing Address - Country:US
Mailing Address - Phone:940-684-1581
Mailing Address - Fax:940-684-1860
Practice Address - Street 1:102 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:CROWELL
Practice Address - State:TX
Practice Address - Zip Code:79227
Practice Address - Country:US
Practice Address - Phone:940-684-1581
Practice Address - Fax:940-684-1860
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAW'S PHARMACY-CROWELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-28
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy