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
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