Organization
JOHN CRAWFORD III DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CRAWFORD III DO (LAB DIRECTOR)
(814) 247-6583
Entity
Organization
Contact information
Practice address
170 FOURTH AVE, HASTINGS, PA 16646
(814) 247-6583
(814) 247-8219
Mailing address
PO BOX 629, 170 FOURTH AVENUE, HASTINGS, PA 16646-0629
(814) 247-6583
(814) 247-8219
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
022586
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005860850001
—
PA
01
—
0015339070001
MEDICAID LABORATORY
PA
01
—
84604
UNISON LABORATORY
PA
Enumeration date
06/16/2008
Last updated
06/16/2008
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