Organization
CROSSROADS PHARMACY
Active
Other names
CrossRoads Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
O'RITA SIDDALL (PHARMACY MANAGER)
(214) 308-1963
Entity
Organization
Contact information
Practice address
3220 GUS THOMASSON RD STE 237, MESQUITE, TX 75150-4051
(214) 308-1963
(214) 432-8274
Mailing address
PO BOX 271402, DALLAS, TX 75227-9579
(214) 308-1963
(214) 432-8274
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27009
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126598
PK
—
Enumeration date
07/17/2010
Last updated
12/21/2015
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