Most Relevant Information
Provider Data
| NPI Number: | 1003403460 |
| Provider Name: | T ELAINE FAIR CRUMP |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 26015493A |
Most Important Dates
| Enumeration Date: | 12/30/2020 |
| Last Updated: | 12/30/2020 |
Provider Practice Location
1150 HUSKY TRL
WARSAW
IN
465821952
Practice Location Phone/Fax
| Phone: | 5743719080 |
| Fax: | 5743719081 |
Provider Mailing Location
22345 SOMMERSET PLACE BLVD
GOSHEN
IN
465288317
Provider Mailing Phone/Fax
| Phone: | 5749035433 |
| Fax: |