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Organization

CROSS LANES FAMILY PHARMACY INC

Active
Other names
CROSS LANES FAMILY PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
BRAC BROWN RPH (PHARMACIST SOLE OWNER)
(304) 204-2588
Entity
Organization

Contact information

Practice address
107 GOFF MOUNTAIN RD, CROSS LANES, WV 25313-1430
(304) 204-2588
(304) 204-2591
Mailing address
107 GOFF MOUNTAIN RD, CROSS LANES, WV 25313-1430
(304) 204-2588
(304) 204-2591

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
SP0552317
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2111559
PK
05
3810002984
WV
Enumeration date
09/20/2006
Last updated
02/20/2017
About Stedi
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  • EDI platform