Organization
CROSSROADS HEALTH SERVICES
Active
Other names
Crossroads Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PRASAD MATTUPALLI (PHARMACIST)
(443) 528-1010
Entity
Organization
Contact information
Practice address
4801 DORSEY HALL DR STE 120, ELLICOTT CITY, MD 21042-7703
(410) 203-1108
Mailing address
4801 DORSEY HALL DR, SUITE 120, ELLICOTT CITY, MD 21042-7766
(410) 203-1108
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155361
PK
—
Enumeration date
11/23/2015
Last updated
11/23/2015
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